Tamil - Diabetes NSW

Transcription

ePupopT Neha;
ePq;fs; njhpe;J nfhs;s Ntz;baJ vd;d
1
ENGLISH/TAMIL
Contents
ChapterIndex
Foreword
Introduction
1
What is diabetes
2
Types of diabetes Type 1 diabetes
Type 2 diabetes
Gestational diabetes
3
Risk factors
4
The Diabetes Health Care Team 5
Annual Cycle of Care
6
Healthy Eating for Diabetes
7
What’s in food?
8
Common Questions about Food and Diabetes
9
Diabetes and Alcohol
10
Physical activity
11
Oral Medications 12
Insulin 13
Blood Glucose (Sugar) Monitoring 14
Short Term Complications – Hypoglycaemia 15
Short term complications – high blood glucose (sugar) level (hyperglycaemia,
DKA, HONK/HHS, and sick days)
16
Chronic complications
17
Diabetes and your feet
18
Diabetes and Pregnancy
19
Diabetes and Your Emotions
20
Diabetes and Driving
21
Diabetes and Travel
22
Need an Interpreter? 23
National Diabetes Services Scheme (NDSS) 24
Australian Diabetes Council 2
nghUslf;fk;
mj;jpahak; ml;ltiz
Kd;Diu
mwpKfk; 1 ePhpopT Neha; vd;why; vd;d 2 ePhpopT Nehapd; tiffs;
ePhpopT Neha; tif 1 3
4
5
6
7
8
9
10
11
12
13
ePhpopT Neha; tif 2 fHg;gfhy ePhpopT Neha; mghaf; fhuzpfs; ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FO guhkhpg;gpy; tUlhe;jpur; Row;rp ePhpopT Neha;f;Fr; rj;JzT cztpy; vd;d cs;sJ?
czT kw;Wk; ePhpopT Neha; gw;wpa nghJthd Nfs;tpfs;
ePhpopT NehAk;> kJTk;
cly;hPjpahd nray;ghLfs; tha;top kUe;Jfs;
,d;Rypd; ,uj;j FSNfh]; (rHf;fiu) msitf; fz;fhzpj;jy; 14 FWfpa fhy rpf;fy;fs; - ,uj;jj;;jpy; rHf;fiuf; FiwT
(Hypoglycaemia) 15 Fiwe;jfhy gpur;rpidfs; - caH ,uj;j FSNfh]; (rHf;fiu) msT
(,uj;jj;jpy; $Ljy; rHf;fiu vdg;gLk; i`Nghfpisrpkpah>
DKA, HONK/HHS kw;Wk Neha;tha;g;gl;l ehl;fs;) 16 ehl;gl;l rpf;fy;fs;
17 ePhpopT NehAk;> cq;fs; ghjq;fSk;
18 ePhpopT NehAk;> fUj;jhpg;Gk; 19 ePhpopT NehAk;> cq;fs; czHr;rpfSk;
20 ePhpopT NehAk;> thfdk; Xl;LjYk;
21 ePhpopT NehAk;> gazKk; 22 nkhopngaHj;Jiug;ghsH Njitg;gLfpwjh? 23 Njrpa ePhpopT Neha; Nritfs; jpl;lk; (NDSS)
24 M];jpNuypa ePhpopT Neha;f; fofk;
3
Foreword
Diabetes –What you need to know has been written for people with diabetes and for people
who would like to learn more about the condition.
Health professionals with skills and knowledge in a variety of specialised areas have
contributed to the content and presentation.
This book has been reviewed by diabetes educators, dietitians and exercise physiologists.
Australian Diabetes Council
email: [email protected]
websites: www.australiandiabetescouncil.com
www.diabeteskidsandteens.com.au
abn 84 001 363 766 CFN 12458
26 Arundel Street, Glebe, NSW 2037
GPO Box 9824, Sydney, NSW 2001
© 2012 Copyright Australian Diabetes Council
This article/ resource has copyright. Apart from any fair dealing for the purposes of private study, research, criticism
or review permitted under the Copyright Act 1968, no part may be stored or reproduced by any process without
prior written permission from Australian Diabetes Council.
4
Kd;Diu
• ePhpopT Neha; - ePq;fs; njhpe;J nfhs;s Ntz;baJ vd;d” vd;gJ ePhpopT Neha;
cs;stHfSf;fhfTk;> kw;Wk; ,e;j epiyikiag; gw;wp mjpfk; njhpe;J nfhs;s
tpUk;;GgtHfSf;fhfTk; vOjg;gl;lJ.
gy;NtW rpwg;Gj; Jiwfspy; jpwikAk;> mwpTk; cs;s Rfhjhu epGzHfs; ,jw;Fhpa
jfty;fisAk;> fhl;rpfisAk; nfhLj;J cjtpAs;sdH.
,e;jg; Gj;jfk; ePhpopT Neha;f; fy;tpahsHfshYk;> czTf; fl;Lg;ghL epGzHfshYk;>
clw;gapw;rp clypayhsHfshYk; kWMa;T nra;ag;gl;Ls;sJ.
Australian Diabetes Council
email: [email protected]
websites: www.australiandiabetescouncil.com
abn 84 001 363 766 CFN 124586
26 Arundel Street, Glebe, NSW 2037
GPO Box 9824, Sydney, NSW 2001
© 2012 Copyright Australian Diabetes Council
This article/ resource has copyright. Apart from any fair dealing for the purposes of private study, research, criticism
or review permitted under the Copyright Act 1968, no part may be stored or reproduced by any process without
prior written permission from Australian Diabetes Council.
5
Introduction
One in four people in Australia have either diabetes or are at high risk of diabetes.
Diabetes prevalence is considerably higher in Aboriginal and Torres Strait Islander and certain
culturally and linguistically diverse (CALD) groups.
So far there is no cure for diabetes but with proper management most people can lead a full
and active life and delay or prevent long term complications. To ensure
best possible health, people with diabetes and their families need to understand a great deal
about diabetes.
Being diagnosed with diabetes can be frightening and overwhelming. It’s a lot easier
when you understand it and develop a lifestyle plan to manage it. For this reason it is very
important to have information about food, medicines, exercise, community resources and
diabetes self care.
This book has been produced by Australian Diabetes Council. It has been written in English
and several other languages to explain what you need to know about diabetes.
6
mwpKfk;
M];jpNuypahtpy; ehd;F Nghpy; xUtH ePhpopT Nehapdhy; ghjpf;fg;gl;bUf;fpwhHfs;
my;yJ ePhpopT Neha;f;F Ml;gLk; ngUj;j mghaj;jpy; ,Uf;fpwhHfs;.
G+HtPff; FbapdH kw;Wk; Nlhu]; tisFlh jPTg; gFjpapdUf;Fk;> gz;ghl;bYk;>
nkhopapYk; (culturally and linguistically) NtWgl;l rpy (CALD) FOtpdUf;Fk; ePhpopT
Nehapd; jhf;fk; XusTf;F mjpfkhf ,Uf;fpwJ.
ePhpopT Nehiaf; Fzg;gLj;j ,Jtiu ve;j kUe;Jk; fpilahJ. Mdhy; rhpahf
epHtfpg;gjd; %yk; gy NgH KOikahd> RWRWg;ghd tho;f;ifia tho KbAk;.
mj;Jld; ePz;lfhy rpf;fy;fisj; jLf;f KbAk;. Kbe;j msT cly;eyj;ij cWjp
nra;a> ePhpopT Neha; cs;stHfSk; mtHfs; FLk;gKk; ePhpopT Nehiag; gw;wpa KO
tptuq;fis mwpe;Jnfhs;tJ mtrpakhFk;.
ePhpopT Neha; ,Uf;fpwJ vd;W fz;Lgpbf;fg;gl;lhy; me;j epidg;Ng gaj;ijf;
nfhLj;J> KOtJkhf Mf;fpukpj;Jf; nfhs;Sk;. mijg; Ghpe;Jnfhz;L> epHtfpf;fj;
jFe;j tho;f;if Kiwia cUthf;fpf; nra;J nfhz;lhy;> mJ kpfTk;
vspjhfptpLk;. ,e;jf; fhuzj;jpdhy; czT> kUe;J tiffs;> clw;gapw;rp> r%f
Mjhuq;fs; kw;Wk; ePhpopT Neha; Raguhkhpg;G ,itfisg; gw;wpa jfty;fs; kpfTk;
mtrpakhFk;.
,e;jg; Gj;jfk; M];jpNuypa ePhpopT Neha;f; fofj;jpdhy; ntspaplg;gl;Ls;sJ. ,J
ePhpopT Nehiag; gw;wp ePq;fs; vd;ndd;d mwpe;Jnfhs;s Ntz;Lk; vd;gij tpsf;fp
Mq;fpyj;jpYk; kw;Wk; gy nkhopfspYk; vOjg;gl;Ls;sJ.
7
1
What is diabetes?
Diabetes is a condition where the amount of glucose (sugar) in the blood is too high.
Glucose is your body’s main energy source but when blood glucose is too high over long
periods it can damage certain organs.
Glucose comes from carbohydrate foods that are broken down and released into the
bloodstream. Carbohydrate foods include bread, rice, potatoes, fruit and milk.
The pancreas, a part of the body that is found behind the stomach, releases a hormone
called insulin into the blood stream. Insulin allows the glucose to move from the blood
stream into certain cells of the body, where it is changed into energy. We use this energy to
walk, talk, think, and carry out many other activities.
Diabetes occurs when there is either no insulin, not enough insulin or the insulin that is
produced is not working properly to move the glucose out of the blood. .
Currently there is no cure for diabetes.
Symptoms of high blood glucose (sugar)
2
1.
2.
3.
4.
5.
6.
7.
8.
Frequent urination (both night and day)
Thirst / dry mouth
Tiredness / lack of energy
Blurred vision
Slow healing of wounds
Infections e.g. urine and skin
Tingling sensation in feet
Itchy skin
Types of diabetes
The most common types of diabetes include:
• Type 1 diabetes
• Type 2 diabetes
• Gestational Diabetes (GDM)
8
1
ePhpopT Neha; vd;why; vd;d?
ePhpopT Neha; vd;gJ ,uj;jj;jpy; FSNfh]; (rHf;fiu) msT kpf mjpfkhf
,Uf;Fk; epiyahFk;.
FSNfh]; cq;fs; clYf;F gpujhd rf;jpiaf; nfhLf;fpwJ. Mdhy; ,uj;jj;jpy;
FSNfh]; ePz;l fhyk; kpf mjpfkhf ,Ue;jhy;> mJ rpy clYWg;Gfisr;
Nrjg;gLj;jf; $Lk;.
khTr;rj;J (fhHNghi`l;Nul;) cs;s czTfspy; ,Ue;J FSNfh]; fpilf;fpwJ.
khTr;rj;Jf;fs; Jz;lhf;fg;gl;L ,uj;j Xl;lj;jpy; fyf;fpd;wd. nuhl;b> mhprp>
cUisf;fpoq;F> gok; kw;Wk; ghy; Nghd;wit khTr;rj;Js;s czTfspy; mlq;Fk;.
clypd; XH mq;fkhd fizak;> tapw;Wf;Fg; gpd;Gwj;jpYs;sJ. mJ ,d;Rypd; vd;w
`hHNkhidr; Rue;J ,uj;j Xl;lj;jpy; fyf;fpwJ. ,d;Rypd; FSNfhi] ,uj;j
Xl;lj;jpypUe;J clypYs;s rpy nry;fSf;Fr; nry;y mDkjpf;fpwJ. mq;Nf mJ
rf;jpahf khw;wg;gLfpwJ. ehk; ,e;j rf;jpiag; gad;gLj;jp elf;fpNwhk;;> NgRfpNwhk;>
epidf;fpd;Nwhk; kw;Wk; gy;NtW Ntiyfisr; nra;fpNwhk;.
,d;Rypd; xd;WNk ,y;yhjNghJ my;yJ NghJkhd msT ,y;yhjNghJ my;yJ
Rue;j ,d;Rypd; FSNfhi] ,uj;jj;ij tpl;L ntspNaw;Wk; Ntiyiar; rhpahf
nra;ahjNghJ ePhpopT Neha; Vw;gLfpwJ.
jw;NghJ ePupopT Nehiaf; Fzg;gLj;j ve;j kUe;Jk; fpilahJ.
caH ,uj;j FSNfh]pd; (rHf;fiu) mwpFwpfs;
2
1.
2.
3.
4.
5.
6.
7.
8.
mbf;f rpWePH fopj;jy; (,uTk; gfYk;)
jhfk; / cyHe;j tha;
NrhHT / rf;jpapd;ik
kq;fyhd ghHit
fhaq;fs; nkJthf MWjy;
Neha;j; njhw;Wfs;> vLj;Jf;fhl;lhf rpWePH kw;Wk; Njhy;
ghjj;jpy; FWFWg;ghd czHT
Njhy; mhpg;G
ePhpopT Nehapd; tiffs;
ePhpopT Nehapd; nghJthd tiffspy; gpd;tUgit mlq;Fk;
• ePhpopT Neha; tif 1
• ePhpopT Neha; tif 2
• fHg;gfhy ePhpopT Neha; (GDM)
9
Types of diabetes - continued
Type 2 diabetes
This type of diabetes usually occurs in children and young people, but it can occur at any age.
In type 1 diabetes the body’s immune (defence) system has destroyed the cells that make
insulin. As a result no insulin is produced by the pancreas.
The development of type 1 diabetes is NOT linked to lifestyle e.g. eating too much sugar, not
exercising enough or being overweight.
Symptoms of type 1 diabetes usually happen very quickly and include:
• Feeling very thirsty
• Passing a lot of urine frequently
• Sudden weight loss (despite normal or increased appetite)
• Tiredness
• Generally feeling unwell
• Abdominal pain, nausea and vomiting
• Mood changes.
If undetected, blood glucose levels become very high. When the body cannot get enough
glucose from the blood to use as energy it will begin to breakdown fat. When the body is
breaking down too much fat, ketones are produced. High ketone levels and high blood glucose levels are very serious and need immediate medical treatment.
If untreated, the person will become very ill and may develop:
• Rapid or deep breathing
• Dehydration and vomiting, leading to
• Coma.
The treatment for type 1 diabetes is insulin which must be commenced immediately and
must be taken for life. The management of type 1 diabetes also includes:
• Balancing exercise, food and insulin
• Regular blood glucose monitoring
• Healthy lifestyle.
10
ePhpopT Nehapd; tiffs; - njhlUk;
ePhpopT Neha; tif 1
,e;j tif ePhpopT Neha; tif nghJthf Foe;ijfSf;Fk; ,isa tajpdUf;Fk;
tUk;. MapDk; ve;j tajpdUf;Fk; tuyhk;.
ePhpopT Neha; tif 1-,y; clypd; Neha; vjpHg;G (ghJfhg;G) mikg;ghdJ
,d;Rypidr; Ruf;fpd;w nry;fis mopj;J tpLfpwJ. mjd; tpisthf fizak;
,d;Rypidr; Rug;gjpy;iiy.
ePhpopT Neha; tif 1 cUthtJ vd;gJ rHf;fiu mjpfk; rhg;gpLtJ>
clw;gapw;rp Njitahd msT vLf;fhjJ my;yJ mjpf gUkdhapUg;gJ Nghd;w
tho;fi
; fKiwNahL rk;ge;jg;gl;lJ my;y.
ePhpopT Neha; tif 1-,d; mwpFwpfs; nghJthf cldbaha;j; njhpatUk;. me;j mwpFwpfspy; gpd;tUgit mlq;Fk;:
• mjpfkhfj; jhfnkLj;jy;
• mbf;fb rpWePH mjpfkhff; fopj;jy;
• cldbahf vil Fiwjy; (tof;fkhd my;yJ $Ljyhd grp ,Ue;j NghjpYk;)
• NrhHT
• nghJthf cly;eykpd;ik
• tapw;W typ> Fkl;ly;; kw;Wk; the;jp
• kNdhghtk; khWjy;.
fz;Lgpbf;ftpy;iyahdhy;> ,uj;j FSNfh]; msT kpfTk; mjpfkhfp tpLk;.
rf;jpahfg; gad;gLj;jpf; nfhs;s clYf;Fj; Njitahd msT FSNfh];
,uj;jj;jpypUe;J fpilf;f ,ayhky; Nghdhy;> mJ nfhOg;ig cilf;f Muk;gpj;J
tpLk;. cly; mjpf mstpy; nfhOg;ig cilf;f Muk;gpj;Jtpl;lhy;> fPNlhd;fs;
cw;gj;jpahf Muk;gpj;JtpLk;. mjpfg;gbahd fPNlhd; msTfSk;> caH ,uj;j FSNfh]; msTfSk; kpfTk; Mgj;jhdit. mjw;F cldb kUj;Jtr; rpfpr;irj;
Njitg;gLk;.
rpfpr;ir mspf;fhky; Nghdhy;> me;j egH RftPdKw;W> gpd;tUk; tpisTfisr;
re;jpg;ghH:
• Ntfkhd my;yJ Mo;ej
; Rthrk;
• ePHr;rj;J Fiwjy;; kw;Wk; the;jp> mijj; njhlHe;J
• Nfhkh.
ePhpopT Neha; tif 1-f;F rpfpr;ir ,d;Rypd;. mJ cldbahfj; njhlq;fg;gl
Ntz;Lk;. mj;Jld; tho;fi
; f KOtJk; vLj;Jf; nfhs;sg;gl Ntz;Lk;. ePhpopT Neha;
tif 1-I epHtfpg;gjpy; gpd;tUgitfSk; mlq;Fk;:
• rhptpfpjkhd clw;gapw;rp> czT kw;Wk; ,d;Rypd;
• njhlHe;j ,uj;j FSNfh]; fz;fhzpg;G
• MNuhf;fpakhd tho;fi
; fKiw.
11
Type 2 diabetes
This type of diabetes is usually diagnosed in people over 40 years of age. However it is now
being diagnosed in younger people, including children. Poor lifestyle choices are a major
reason for this increase in young people .
Inactivity and poor food choices can result in weight gain, especially around the waist.
This prevents the body from being able to use insulin properly (insulin resistance) so blood
glucose levels rise. Type 2 diabetes has a slow onset.
Type 2 diabetes runs in families so children and grandchildren are at risk. The good news is
that type 2 diabetes can be delayed or prevented when healthy lifestyle choices that focus
on increasing physical activity, healthy food choices and weight loss are made. For this reason
it is important to know your risk for type 2 diabetes.
Symptoms of type 2 diabetes may include frequent urination, thirst, blurred vision, skin
infections, slow healing, tingling and numbness in the feet. Often, there are no symptoms
present, or symptoms are not recognised.
Once diagnosed, it is very important to maintain good blood glucose (sugar) levels as soon
as possible to avoid complications.
Management should begin with healthy food choices and regular physical activity. However,
diabetes is a progressive disease and over time, oral medications and/or insulin may be needed.
12
ePhpopT Neha; tif 2
,t;tif ePhpopT Neha; nghJthf 40 taJf;F Nkw;gl;l kf;fsplk; ,Ug;gjhff;
fz;lwpag;gl;Ls;sJ. ,Ug;gpDk; ,J Foe;ijfs; cl;gl ,isa tajpdhplKk;
,Ug;gjhf jw;NghJ fz;lwpag;gl;Ls;sJ. Nkhrkhd tho;f;if Kiwiaj;
NjHe;njLg;gJjhd; ,isa kf;fsplk; ,e;j caHTf;F Kf;fpa fhuzkhFk;.
Ntiy nra;ahky; ,Ug;gJk;> jtwhd czTg; gof;fq;fSk; cly; vilia>
Fwpg;ghf> ,Lg;igr; Rw;wp viliaf; $l;Lfpd;wd. ,J cliy ,d;Rypidg;
gad;gLj;jj; jilaha; ,Uf;fpwJ (,d;Rypd; jLg;G). MfNt ,uj;j FSNfh];
msTfs; caHfpd;wd. ePhpopT Neha; tif 2 nky;yj; jhf;FtjhFk;.
ePhpopT Neha; tif 2 FLk;gq;fSf;Fs; tisa tUtjhy; Foe;ijfSk;>
Ngug;gps;isfSk; mghaj;Jf;Fs;shfpwhHfs;. ,jpy; ey;y nra;jp vd;dntd;why;>
cly; nray;ghLfisf; $l;Ljy;> rj;jhd czitj; NjHe;njLj;jy;
kw;Wk; viliaf; Fiwj;jy; Nghd;wtw;wpy; ftdk; nrYj;Jk; Rfhjhukhd
tho;f;ifKiwiaj; NjHe;njLj;jhy; ePhpopT Neha; tif 2-Ij; jhkjg;gLj;jNth>
jLf;fNth KbAk;. ,jd; fhuzkhf ePhpopT Neha; tif 2-,;y; cq;fSf;F cs;s
mghaj;ij mwpe;J nfhs;tJ mtrpakhFk;.
ePhpopT Neha; tif 2-,d; mwpFwpfspy; mbf;fb rpWePH fopj;jy;> jhfnkLj;jy;>
ghHit kq;fy;> Njhy; njhw;WNeha;fs;> nkJthff; Fzkhjy;> ghjj;jpy;
FWFWg;ghd czHT kw;Wk; kuj;Jg; Nghjy; Nghd;witfSk; ,Uf;fyhk;.
ngUk;ghYk; mwpFwpfs; fhzg;glhkNyh> fz;Lgpbf;fg;glhkNyh ,Uf;Fk;.
fz;lwpag;gl;lhy;> rpf;fy;fisj; jtpHg;gjw;F ,uj;j FSNfh]; (rHf;fiu) msitr;
cldbahfr; rPHg;gLj;Jjy; mtrpakhFk;.
rj;jhd czitj; NjHe;njLj;jy; kw;Wk; xOq;fhd cly; nray;ghLfspy;
epHthfpf;fj; njhlq;f Ntz;Lk;. ,Ug;gpDk;> ePhpopT Neha; vd;gJ xU
tsHe;Jnfhz;bUf;Fk; NehahFk;. fhyj;Jf;Fk; tha;top kUe;JfSk; kw;Wk; / my;yJ
,d;RypDk; Njitg;glyhk;.
13
Type 2 Management Plan
• Be physically active (e.g. walking) – aim for 30 minutes of moderate physical activity every
day of the week. Check with you doctor first
• Adopt a healthy eating plan
• Lose weight or maintain a healthy weight
• Reduce salt intake
• Drink plenty of water
• See your diabetes health care team for regular health checks –, blood glucose levels,
blood pressure, cholesterol, kidneys and nerve function, eyes and dental health
• Take care of your feet - check daily
• Stop smoking
• Regular dental care to avoid teeth and gum problems.
Encourage your family to adopt a healthy lifestyle.
Smoking and diabetes
Tobacco has many unhealthy effects, especially for people with diabetes. People with
diabetes who smoke are three times more likely to die of heart disease or stroke than people
with diabetes who do not smoke.
Smoking raises blood glucose levels, reduces the amount of oxygen reaching the body’s
tissues, increases fat levels in the blood, damages and constricts blood vessels and increases
blood pressure. All of these contribute to the risk of heart attack and stroke. Smoking can also
worsen blood supply to feet.
For those who quit smoking, more frequent monitoring of blood glucose levels is important.
This is because blood glucose levels may get lower when they quit smoking and can require
changes to medication doses.
It is advisable that people with diabetes discuss with their doctor, the products and services
available to help them quit smoking.
14
epHthfj; jpl;lk; tif 2
• cly;hPjpahfr; RWRWg;ghf ,Uq;fs; (vLj;Jf;fhl;lhf> eilg;gapw;rp) thuj;jpd;
xt;nthU ehSk; 30 epkpl cliyg; NgZk; kpjkhd nray;ghl;ilf; Fwpf;Nfhshf
itj;jpUq;fs;. Kjypy;; cq;fs; kUj;Jthplk; rhpghHj;Jf; nfhs;Sq;fs;
• xU rj;JzTj; jpl;lj;ijg; gpd;gw;Wq;fs;
• viliaf; FiwAq;fs; my;;yJ MNuhf;fpakhd viliag; guhkhpAq;fs;
• cg;G cl;nfhs;tijf; FiwAq;fs;
• epiwa jz;zPH FbAq;fs;
• xOq;fhd Rfhjhur; NrhjidfSf;F - ,uj;jj;jpy; rHf;fiu msT> ,uj;j mOj;jk;> nfhOg;G>
rpWePuf kw;Wk; euk;G nray;ghLfs;> fz; kw;Wk; gy; Rfhjhuk; Nghd;witfSf;F cq;fs; ePhpopT
Neha;r; Rfhjhug; guhkhpg;Gf; FOitg; ghUq;fs;
• cq;fs; ghjq;fisg; guhkhpj;Jf; nfhs;Sq;fs; - xt;nthU ehSk; rhpghHj;Jf; nfhs;Sq;fs;
• Gifgpbg;gij epWj;Jq;fs;
• gy; kw;Wk; <W rk;ge;jg;gl;l gpur;rpidfisj; jtpHf;f xOq;fhf gw;fisg; guhkhpAq;fs;.
Rfhjhukhd tho;f;ifKiwiag; gpd;gw;w cq;fs; FLk;gj;ij Cf;FtpAq;fs.;
Gifgpbj;jYk;> ePhpopT NehAk;
Gifapiy cly;eyj;Jf;Fj; jPq;fhd mNef tpisTfis> mjpYk; Fwpg;ghf ePhpopT Neha;
cs;stHfSf;F cz;lhf;FfpwJ. Gifgpbf;Fk; gof;fKs;s ePhpopT Neha; cs;stHfs;> Gifgpbf;Fk;
gof;fkpy;yhj ePhpopT Neha; cs;stHfisf; fhl;bYk; %d;W klq;F ,ja NehahNyh my;yJ
%isapy; ,uj;jehs milg;ghNyh kuzkilAk; tha;g;G mjpfk; cs;sJ.
Gifgpbj;jy;; ,uj;jr;; rHf;fiu msit caHj;jp> cly; jpRf;fSf;Fr; nry;;Yk; Mf;]p[d; msitf;
Fiwj;J> ,uj;jj;jpy; nfhOg;G msitf; $l;b> ,uj;j ehsq;fis Nrjg;gLj;jpf; FWf;Ftjd; %yk;>
,uj;j mOj;jj;ijAk; caHj;JfpwJ. ,it midj;Jk;> khuilg;G kw;Wk; %isapy; ,uj;jehs
milg;G Nghd;w mghaj;Jf;Fg; ngUk; gq;fspg;G mspf;fpd;wd.
Gifgpbj;jiy epWj;jpatHfs;> ,d;Dk; mjpf mstpy; mbf;fb ,uj;jr; rHf;fiu msTfisf;
fz;fhzpf;f Ntz;baJ mtrpakhFk;. Vndd;why; mtHfs; Gifgpbj;jiy epWj;jpaTld; ,uj;jr;
rHf;fiu msTfs; Fiwayhk;. mjdhy; kUe;J vLf;Fk; mstPLfspy; khw;wk; Njitg;gLk;.
ePhpopT Neha; cs;stHfs; Gifgpbj;jiy epWj;j cjtf;$ba nghUl;fs; kw;Wk; Nritfisg; gw;wpj;
jq;fs; kUj;Jthplk; fye;J MNyhrpg;gJ ey;yJ.
15
Gestational Diabetes
This type of diabetes occurs during pregnancy and usually goes
away after the baby is born.
In pregnancy, the placenta produces hormones that help the baby
to grow and develop. These hormones also block the action of the
mother’s insulin. As a result, the need for insulin in pregnancy is
two to three times higher than normal. If the body is unable to
produce enough insulin to meet this extra demand, gestational
diabetes develops.
Screening for gestational diabetes occurs around the 24th to 28th
week of pregnancy. Gestational diabetes may re-occur at the next
pregnancy.
Blood glucose (sugar) levels that remain above target range may
result in bigger babies, which can make birth more difficult. It can
also increase the risk to the baby of developing diabetes in later life.
What do you need to do if you have been diagnosed with gestational diabetes?
It is necessary to see a diabetes educator, dietitian, endocrinologist and obstetrician.
The management includes healthy eating for the mother, moderate exercise plus regular
monitoring of blood glucose levels.
It is a good idea to have small frequent meals throughout the day that are nutritious for
you and your baby, rather than three big meals. This will ease the insulin demand on the
pancreas.
Those most at risk for developing gestational diabetes are:
• Women over 30 years of age
• Women with a family history of type 2 diabetes
• Women who are overweight
• Aboriginal or Torres Strait Islander women
• Certain ethnic groups, in particular Pacific Islanders, people from
the Indian subcontinent and people of Asian origin
• Women who have had gestational diabetes during previous
pregnancies.
Women who have had gestational diabetes are at increased risk of developing type 2
diabetes. It is strongly recommended to have a follow up Oral Glucose Tolerance Test 6-8
weeks after the baby is born, then every 1-2 years.
16
fHg;gfhy ePhpopT Neha;
,t;tif ePhpopT Neha; fHg;gkhapUf;Fk;NghJ tUk;. mjd;gpd;
nghJthff; Foe;ij gpwe;j gpwF Ngha;tpLk;.
fUj;jhpj;j Neuj;jpy;> gdpf;Fly; (placenta) Foe;ij tsHe;J>
KjpHe;jpl cjTtjw;F `hHNkhd;isr; Ruf;fpwJ. mjd;
tpisthff; fHg;gfhyj;jpy; ,d;Rypdpd; Njit rhjhuz
msittpl ,uz;bypUe;J %d;W klq;F mjpfhpf;fpwJ. ,e;j
mjpfj; Njitf;Nfw;g cly; Njitahd msT ,d;Rypid
cw;gj;jp nra;atpy;iynad;why;> fHg;gfhy ePhpopT Neha;
Vw;gLfpwJ.
fHg;gfhy ePhpopT Neha;f;fhd ghpNrhjid> fUTw;W
Vwf;Fiwa 24 Kjy; 28-MtJ thuthf;fpy; eilngWk;.
fHg;gfhy ePhpopT Neha; mLj;j fHg;gj;jpy; kWKiwAk;
Vw;glyhk;.
,uj;j FSNfh]; (rHf;fiu) msTfs; Fwpg;gpl;l
tiuaiwf;F Nky; ,Ue;jhy; Foe;ij mstpy; nghpajhfp> Foe;ij gpwg;G kpfTk;
fbdkhfp tpLk;. mJ gpw;fhyj;jpy; mf;Foe;ij ePhpopT Nehahy; ghjpf;fg;glf;$ba
mghaj;ij caHj;jptpLk;.
cq;fSf;Ff; fHg;gfhy ePhpopT Neha; ,Ug;gjhff; fz;Lgpbf;fg;gl;lhy;> ePq;fs; vd;d
nra;a Ntz;Lk;?
ePq;fs; ePhpopT Neha;f; fy;tpahsH> czTf; fl;Lg;ghL epGzH> ehskpy;yhr; Rug;gp
epGzH> kfg;NgW kUj;JtH ,tHfisg; ghHg;gJ mtrpakhFk;.
jha; rj;jhd czit cz;Zjy;> XusT cly; gapw;rp nra;jy;> mj;Jld; ,uj;j
FSNfh]; msTfis xOq;fhff; fz;fhzpj;jy; Nghd;wit Nkyhz;ikapy;
mlq;Fk;.
%d;WNtis fzprkhd czit cz;Ztij tpl cq;fSf;Fk;> cq;fs;
Foe;ijf;Fk; rj;jhd czitr; rpW mstpy; gy jlit cz;Zjy; ey;yJ. mJ
fizaj;Jf;F ,d;Rypd; Njitiar; Rygkhf;fpwJ.
fHg;gfhy ePhpopT Nehahy; ghjpf;fg;gLtjw;fhd mghaj;ij mjpfk; cilatHfs;:
• 30 taJf;F Nkw;gl;l ngz;fs;
• FLk;gg; guk;giuapy; ePhpopT Neha; tif 2 cs;s ngz;fs;.
• mjpf gUkdhd ngz;fs;
• cs;ehl;Lg; goq;Fb (Aboriginal) my;yJ Nlhu]; tisFlhj; jPitr;
(Torres Strait Islander) rhHe;j ngz;fs;
• rpy ,df; FOf;fs;> Fwpg;ghf grpgpf; gpuhe;jpa jPtpy; tho;NthH> ,e;jpaj;
Jizf; fz;lj;jpypUe;J te;j kf;fs; kw;Wk; Mrpa topapy; Njhd;wpa kf;fs;
• Ke;ija fHg;gq;fspy; fHg;gfhy ePhpopT Nehahy; ghjpf;fg;gl;l ngz;fs;.
fHg;gfhy ePhpopT Nehahy; Vw;fdNt ghjpf;fg;gl;l ngz;fs;> ePhpopT Neha; tif
2-My; ghjpf;fg;gLk; mghak; mjpfhpf;fpwJ. Foe;ij gpwe;J 6-8 thuq;fSf;Fg;
gpd;> tha;top FSNfh]; rfpg;Gg; ghpNrhjidia 1-2 tUlq;fSf;F xUKiw
nra;aNtz;Lk;.
17
3
Risk Factors
Risk factors for developing type 2 diabetes include:
• Family history of diabetes
• Overweight and over 45 years of age
• Heart disease, heart attack or stroke
• High blood pressure and over 45 years of age
• Anyone over 55 years of age
• High blood cholesterol
• High blood glucose levels during pregnancy (gestational diabetes)
• Higher than normal blood glucose levels
• Aboriginal, Torres Strait Islander, Pacific Islanders, Indian sub-continent or Chinese cultural
background
• Women with Polycystic Ovarian Syndrome.
The Australian Diabetes Risk Assessment Tool (AUSDRISK) should be used to identify your risk
of developing type 2 diabetes. You can get this risk assessment tool from your doctor or from
www.health.gov.au. Discuss your results with your doctor.
Children and adolescents who are overweight, experiencing increased thirst, urinary
frequency, tiredness and/or who may have a family history of diabetes should also be
tested for diabetes.
One of the main risk factors for developing diabetes is a family (hereditary) link. This means
that if a person has diabetes, there is an increased risk that other members of their family (e.g.
brother, sister, children, grandchildren) will develop diabetes.
Your family needs to be aware of the importance of a healthy lifestyle to delay or prevent
type 2 diabetes. Regular physical activity and healthy food choices will help reduce the risk
of developing type 2 diabetes.
PREVENTION - THE TIME TO ACT IS NOW
People at high risk of type 2 diabetes should be tested by their doctor every year to check for
the possible onset of diabetes.
18
3
mghaf; fhuzpfs;
ePhpopT Neha; tif 2 Vw;gLtjw;Fhpa mghaf; fhuzpfspy; gpd;tUgitAk; mlq;Fk;:
• ePhpopT NehAs;s FLk;gg; guk;giu
• 45f;F Nkw;gl;l tajpy; mjpf cly; gUkd;
• ,ja Neha;> khuilg;G my;yJ %isapy; ,uj;jehs milg;G
• 45f;F Nkw;gl;l tajpy; caH ,uj;j mOj;jk;
• 55 taJf;F Nkw;gl;l midtUk;
• ,uj;jj;jpy; mjpff; nfhOg;G
• fUj;jhpf;Fk; fhyj;jpy; ,uj;jj;jpy; mjpf msT FSNfh]; msTfs;
(fHg;gfhy ePhpopT Neha;)
• rhjhuz msit tpl mjpfg;gbahd ,uj;j FSNfh]; msTfs;
• cs;ehl;L goq;FbapdH> Nlhu]; tisFlh jPtpdH> ,e;jpaj; Jizf;fz;l
my;yJ rPdf; fyhrhug; gpd;Gyk; nfhz;ltHfs;
• fUg;igapy; jpws;fl;b Neha;f;Fwpak; (Polycystic Ovarian Syndrome)
cs;s ngz;fs;.
cq;fSf;F ePhpopT Neha; tif 2 Vw;gLk; mghaj;ijf; fz;Lgpbf;f M];jpNuypa
ePhpopT Neha; mgha kjpg;gPl;L Kiwia (Australian Diabetes Risk Assessment Tool AUSDRISK) ePq;fs; gad;gLj;j Ntz;Lk;. ,e;j kjpg;gPl;L Kiwia ePq;fs; cq;fs;
kUj;JthplkpUe;Njh www.health.gov.au vd;w ,izajsj;jpypUe;Njh ngwyhk;. mjd;
KbTfis cq;fs; kUj;Jthplk; fye;J MNyhrpj;Jf; nfhs;syhk;.
mjpf cly; gUkd;. mjpfkhd jhfk;> mbf;fb rpWePH ntspNaw;wk;> fisg;G kw;Wk;
/my;yJ ePhpopT Nehiaj; jk;Kila FLk;gg; guk;giuapy; nfhz;Ls;s Foe;ijfs;
kw;Wk; tpliyfSf;F ePhpopT Neha;f;fhd ghpNrhjidfs; Nkw;nfhs;sg;gl Ntz;Lk;.
ePhpopT Neha; Vw;gLtjw;fhd gytpjkhd Kf;fpa mgha fhuzpfspy; FLk;g (guk;giu
top) ,izg;Gk; xd;whFk;. mjhtJ xU egUf;F ePhpopT Neha; ,Ue;jhy;> mtuJ
FLk;gj;jpYs;s kw;w mq;fj;jpdHfSf;Fk; (vLj;Jf;fhl;lhf> rNfhjud;> rNfhjhp>
Foe;ijfs;> Nguf;Foe;ijfs;) ePhpopT Neha; tUtjw;fhd mjpfg;gbahd mghak;
cs;sJ.
ePhpopT Neha; tif 2-I jhkjg;gLj;jNth> jLf;fNth xU MNuhf;fpakhd
tho;f;ifKiwapd; Kf;fpaj;Jtj;ij cq;fs; FLk;gk; mwpe;Jnfhs;tJ mtrpakhFk;.
xOq;fhd cly; ciog;G kw;Wk; rj;jhd czTj; njhpTfs; ePhpopT Neha; tif 2
Vw;gLtjw;fhd mghaj;ijf Fiwf;f cjTfpwJ.
Neha;j;jLg;G – nraypy; ,wq;f ,g;NghNj rhpahd Neuk;
ePhpopT Neha; tif 2 Vw;gLtjw;fhd mghak; cs;s egHfs;> ePhpopT Neha; tUk;
tha;g;gpidj; jq;fSila kUj;JtH %yk; xt;nthU tUlKk; ghpNrhjid
nra;Jnfhs;s Ntz;Lk;.
19
4
The Diabetes Health Care Team
Diabetes is a lifelong condition. Your health care team is available to support, advise and answer
your questions.
The most important member of this team is you!
You are the one who will be at the centre of your diabetes management. Your family, friends
and co-workers might also be part of your team.
The Diabetes Health Care Team includes:
• Your family doctor who looks after your diabetes and refers you to other health
professionals as needed. Your family doctor is responsible for organising your diabetes tests.
• An Endocrinologist is a specialist in diabetes. Many people with type 1 diabetes see an
endocrinologist. People with type 2 diabetes may see an endocrinologist if they are having
problems with their diabetes management or when
insulin therapy is needed.
• A Diabetes Educator is usually a registered nurse
who has done special training in diabetes. Educators
can assist with teaching you about diabetes in
many of the important areas such as blood glucose
monitoring, medications, insulin, sick days, travel and
stress.
• A Dietitian can answer questions about healthy
eating for you and your family.
• An Exercise Physiologist can help to develop a
physical activity plan suitable for you - regardless of
age, ability or disability.
• An Optometrist will do a diabetes eye check and
a vision check. Some people with diabetes need
to see an Ophthalmologist, a doctor with special
training in diseases and problems with the eye.
• A Podiatrist is a health professional who deals with the feet. Many podiatrists have advanced
training in caring for the ‘diabetic foot’.
• A Dentist will check your teeth and gums.
Sometimes people with diabetes have trouble coping with the day to day burden of their
disease. Social workers and psychologists can help in this area. Your family doctor or
diabetes educator can often refer you to these services.
Other specialists are sometimes needed. Children and adolescents with diabetes should see
a paediatric endocrinologist or a paediatrician.
Women with diabetes who are planning a pregnancy, who are pregnant or women
who develop gestational diabetes should see an obstetrician and endocrinologist. If
complications of diabetes are present, referral to other health professionals may be required.
Pharmacists are also very important in your diabetes management. They have special
knowledge of how medicines work and which medications may interact with each other.
Ask your doctor or diabetes health care team about any structured diabetes education
classes/programs in your area. Diabetes education programs, either individual or as part of
a group, will help you set some healthy lifestyle goals and assist you with managing your
diabetes.
20
4
ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FO
ePhpopT Neha; tho;ehs; KOtJk; ePbf;fpd;w epiyikahFk;. cq;fis Mjhpf;f>
MNyhrid toq;f kw;Wk; cq;fs; Nfs;tpfSf;Fg; gjpyspf;f ePhpopT Neha; Rfhjhug;
guhkhpg;Gf; FO ,Uf;fpwJ.
,e;jf; FOtpd; kpf Kf;fpakhd mq;fj;jpdH ePqf
; s;jhd;!
cq;fs; ePhpopT Nehia epHtfpg;gjpy; eLehafkha; ,Uf;fg;NghtJ ePqf
; s;jhd;. cq;fs;
FLk;gk;> ez;gHfs; kw;Wk; rf gzpahsHfSk cq;fs; FOtpd; gFjpahf ,Uf;fyhk;.
ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FOtpy; gpd;tUNthUk; mlq;FtH:
• cq;fs; FLk;g kUj;JtH ,tH cq;fs; ePhpopT Nehiaf; ftdpj;J> Njitg;gl;lhy;
kw;w Rfhjhuj; njhopy; epGzHfsplk; ghpe;Jiug;gtH. cq;fs; FLk;g kUj;JtHjhd;
cq;fs; ePhpopT Neha; rk;ge;jg;gl;l Nrhjidfis elj;j Vw;ghL nra;Ak;
nghWg;Gs;stH
• ehskpy;yh Rug;gp epGzH (Endocrinologist)
ePhpopT Neha;ff
; hd rpwg;G kUj;JtH. ePhpopT
Neha; tif 1 nfhz;Ls;s gyNgH> ehskpy;yh
Rug;gp epGziuj;jhd; ghHf;fpwhHfs;. ePhpopT
Neha; tif 2 nfhz;Ls;stHfs;> mtHfspd;
ePhpopT Neha; epHthfj;jpy; gpur;rpidfs;
,Ue;jhNyh> ,d;Rypd; kUj;Jtr; rpfpr;ir
Njitg;gl;lhNyh ehskpy;yh Rug;gp
epGzHfisg; ghHf;fyhk;
• ePhpopT Neha;f; fy;tpahsH (Diabetes Educator)
nghJthf ePhpopT Nehapy; rpwg;Gg; gapw;rp ngw;w>
gjpTnra;ag;gl;l xU nrtpypauhf ,Ug;ghH.
,uj;j FSNfh]; fz;fhzpg;G> kUe;J
tiffs;> ,d;Rypd;> Neha;tha;gg
; l;l
ehl;fs;> gpuahzk; kw;Wk; kd mOj;jk;
Nghd;w Kf;fpakhd tptuq;fs; gytw;wpy;
ePhpopT Nehiag; gw;wpa fy;tpiaf; fw;gpf;ff;
fy;tpahsHfs; cjtpGhpa KbAk;
• czTf; fl;Lg;ghL epGzH (Dietitian) cq;fSf;Fk;> cq;fs; FLk;gj;Jf;Fk;
rj;JzT tifisg; gw;wpa Nfs;tpfSf;F gjpyspf;f KbAk;
• clw;gapw;rp clypayhsH (Exercise Physiologist) cq;fs; taJ> Mw;wy; my;yJ
,ayhik vJthf ,Ue;jhYk; cq;fSf;Fj; jFe;jgbahd cly; nray;ghl;Lj;
jpl;lj;ij cUthf;f cjtpGhpa KbAk;.
• fz; ghpNrhjid epGzH (Optometrist) ePhpopT Neha; fz; ghpNrhjid kw;Wk;
ghHitr; Nrhjid nra;thH. ePhpopT Neha; cs;s rpyNgH fz; rk;ge;jg;gl;l
Neha;fspYk;> gpur;rpidfspYk; rpwg;Gg; gapw;rp ngw;w fz;kUj;Jtiuf;
(Ophthalmologist) fhz Ntz;bajpUf;Fk;.
• ghj rpfpr;ir epGzH (Podiatrist) ghjj;ijf; ifahSfpd;w Rfhjhug;gzp
ty;YeuhFk;. mNef ghjr;rpfpr;ir epGzHfs; ‘ePhpopT Neha;g; ghjq;fisg;’
guhkhpg;gjpy; caH gapw;rp ngw;wtHfs;.
• gy; kUj;JtH (Dentist) cq;fs; gw;fisAk;> <WfisAk; Nrhjid nra;thH.
21
22
rpy rkaq;fspy; ePhpopT Neha; cs;stHfs; Nehapdhy; Vw;gLk; md;whlr; Rikfisj;
jhq;fKbahky; Jd;gg;gLfpwhHfs;. mr;rkj;jpy; r%fr; NrtfHfSk;> kNdhjj;Jt
epGzHfSk; cjtf;$Lk;. cq;fs; FLk;g kUj;JtNuh my;yJ ePhpopT Neha;f;
fy;tpahsNuh ,j;jifa NritfSf;F mt;tg;NghJ cq;fisg; ghpe;Jiuf;ff;$Lk;.
kw;w rpwg;G epGzHfs; rpyNeuq;fspy; Njitg;gLtH. ePhpopT NehAs;s Foe;ijfs;
kw;Wk; tpliyfs; xU Foe;ij kUj;Jt ehskpy;yhr; Rug;gp epGziuNah my;yJ
xU Foe;ij kUj;JtiuNah mtrpak; fhz Ntz;Lk;.
fUj;jhpf;fj; jpl;lkpl;bUf;Fk; my;yJ jw;NghJ fUTw;wpUf;Fk; ngz;fSf;F ePhpopT
Neha; ,Ue;jhNyh> my;yJ ngz;fs; fHg;gfhy ePhpopT Nehiaf; nfhz;bUe;jhNyh
fl;lhak; Foe;ijg;NgW kUj;JtH kw;Wk; ehskpy;yh Rug;gp epGziuf; fhzNtz;Lk;.
ePhpopT Nehapy; rpf;fy;fs; ,Ue;jhy;> kw;w Rfhjhug; gzp epGzHfSf;Fg;
ghpe;Jiuj;jy; Njitg;glyhk;.
kUe;jhSeHfSk; (Pharmacists) cq;fs; ePhpopT Neha; epHthfj;jpy; kpf
Kf;fpakhdtHfshFk;. kUe;Jfs; vt;thW Ntiy nra;fpd;wd kw;Wk; ve;j
kUe;Jtiffs; xd;Nwhnlhd;W NrHe;J nray;Ghpayhk; vd;gijg; gw;wpa rpwg;ghd
mwpT nfhz;ltHfs;.
cq;fs; gFjpapy; cs;s mikg;G hPjpahd ePuopT Neha;f; fy;tp tFg;Gfs; /
nray;jpl;lq;fs; gw;wp cq;fs; kUj;JtH my;yJ ePhpopT Neha; Rfhjhug; guhkhpg;Gf;
FOtplk; NfSq;fs;. ePhpopT Neha;f; fy;tpr; nray;jpl;lq;fs;> jdpahfNth my;yJ
FOtpd; xU gFjpahfNth cq;fSf;Fr; rpy MNuhf;fpakhd tho;f;if Kiwf;fhd
,yf;if mikj;Jf;nfhs;s cjtpGhpAk;. mj;Jld; cq;fs; ePhpopT Nehia epHtfpf;f
cq;fSf;F cjtpGhpAk;.
23
5
Annual Cycle of Care
What regular health checks are recommended?
Regular health checks help to reduce your risk of
developing diabetes complications.
The recommended health checks are:
What needs to be checked?
How often?
Who do you need to see?
Blood pressure
Every visit to your doctor
Your family doctor
Weight, height and waist circumference
Body Mass Index (BMI): if required – this
helps determine if you have a problem
with your weight
Every six months/ more
often if required
Your family doctor
Feet
Daily self check and
Six monthly health
professional checkups
Podiatrist or family doctor
Kidneys: a blood and urine test, to make
sure your kidneys are working well
Once a year/ more often if
required
Your family doctor
HbA1c: this blood test shows your
average blood glucose level over the
past 2 - 3 months
At least six monthly or more
often if not on target
Your family doctor
Lipids: blood fats
required
Family doctor
Eyes
At diagnosis and at least
every two years/ more
often if required
Optometrist / Ophthalmologist
Healthy eating plan
Once a year
Dietitian
Physical activity
Once a year
Your family doctor / exercise
physiologist
Medication
required
Your family doctor
Review self care education
Once a year
Diabetes educator
Review smoking status
Once a year
Your family doctor
Your family doctor, with the help of your health care team, should develop a care plan
to manage your diabetes. This will allow you to access additional Medicare services for
people with chronic conditions.
24
5
guhkhpg;gpy; tUlhe;jpur; Row;rp
vt;tif tof;fkhd Rfhjhur; Nrhjidfs;
ghpe;Jiuf;fg;gLfpd;wd?
tof;fkhd Rfhjhur; Nrhjidfs; ePhpopT Neha;
gpur;rpidfs; Vw;gLk; mghaj;ijf; Fiwf;f
cjTfpd;wd.
ghpe;Jiuf;fg;gLk; Rfhjhur; Nrhjidfs;:
vd;ndd;d ghpNrhjid
nra;ag;gl Ntz;Lk;?
vj;jid Kiw?
ahiu ePq;fs; fhz
Ntz;Lk;?
,uj;j mOj;jk;
cq;fs; kUj;Jtiuf; fhzr;
nry;Yk; xt;nthU KiwAk;
cq;fs; FLk;g kUj;JtH
vil> cauk;> kw;Wk; ,Lg;Gr; Rw;wsTk;
Njitg;gl;lhy;> cly; vilf; FwpaPLk;
(Body Mass Index - BMI) - ,J cq;fs;
vilapd; fhuzkhf cq;fSf;Fg;
gpur;rpid VJk; cs;sjh vd;gij
KbTnra;a cjTfpwJ.
MWkhjj;jpw;F xUKiw /
Njitg;gl;lhy;> mjw;F
NkYk;
ghjk;
jpdKk; RaghpNrhjid
mj;Jld; MW khjj;jpw;F
xUKiw Rfhjhug; gzp
epGzHfshy; ghpNrhjid
ghj rpfpr;ir epGzH my;yJ
FLk;g kUj;JtH
rpWePufq;fs;: cq;fs; rpWePufq;fs;
ed;whf Ntiy nra;fpwjh vd;gij
cWjpg;gLj;jpf;nfhs;s ,uj;jg;
ghpNrhjid> rpWePHg; ghpNrhjid
tUlj;Jf;F xU Kiw /
Njitg;gl;lhy;> mjw;Fk;
NkYk;
HbA1c: ,e;j ,uj;jg; ghpNrhjid fle;j
2-3 khjq;fspy; cq;fs; ruhrhp ,uj;j
FSNfh]; msT vt;tsT vd;gijf;
fhz;gpf;Fk;
Fiwe;j gl;rk; MW
khjj;Jf;F xU Kiw
my;yJ ,yf;if
vl;ltpy;iynad;why; mjw;F
NkYk;
nfhOg;Gfs; (Lipids): ,uj;jf;
nfhOg;Gfs;
Nrhjid nra;tJ
Fiwe;jgl;rk; ,uz;L
tUlq;fSf;F xU Kiw
/ Njitg;gl;lhy;> mjw;Fk;
NkYk;
fz;fs;
Nrhjid nra;tJ
Fiwe;jgl;rk; ,uz;L
tUlq;fSf;F xU Kiw
/ Njitg;gl;lhy;> mjw;Fk;
NkYk;
fz; ghpNrhjid epGzH / fz;
kUj;JtH
rj;JzTj; jpl;lk;
tUlj;jpw;F xUKiw
czTf; fl;Lg;ghL epGzH
cly; nray;ghLfs;
tUlj;jpw;F xUKiw
cq;fs; FLk;g kUj;JtH /
clw;gapw;rp clypayhsH
kUe;J tiffs;
tUlj;jpw;F xUKiw /
Njitg;gl;lhy; mjw;Fk;
NkYk;
Ra guhkhpg;Gf; fy;tpia kW Ma;T
nra;jy;
tUlj;jpw;F xUKiw
ePhpopT Neha;f; fy;tpahsH
Gifgpbf;Fk; epiyia kWMa;T
nra;jy;
tUlj;jpw;F xUKiw
cq;fs; FLk;g kUj;JtH> cq;fs; Rfhjhug; guhkhpg;Gf; FOtpd; cjtpAld;> cq;fs; ePhpopT Nehia
epHtfpf;f xU guhkhpg;Gj; jpl;lj;ijj; jahH nra;a Ntz;Lk;. Neha; ehl;gl;l epiyapy; cs;stHfs;
$Ljy; nkbNfH Nritfisg; ngw ,J cq;fSf;F cjtpnra;Ak;.
25
6
Healthy eating for diabetes
Eating does more than just provide food and building materials for the body. Eating is a
pleasurable and social experience.
Diabetes should not stop you from enjoying food and eating with friends and family. You
can still enjoy special occasions such as family, social, school and religious festivals. Tell your
dietitian, diabetes educator and doctor what you eat and when. Your food and diabetes
medications can be adapted to suit your lifestyle and normal family routine. However you
may need to make changes to your eating habits to keep your diabetes under control and
stay healthy.
Why is healthy eating important?
A healthy diet is one of the most important parts of diabetes management.
Eating well can help to manage your blood glucose (sugar) levels, cholesterol and blood
pressure. Eating well can also help you to maintain a healthy body weight. Being overweight
makes it harder to manage your diabetes. It is therefore important to have a healthy diet to
help you lose excess weight and improve your diabetes management.
It is important that any dietary advice is tailored to your needs. That is where your dietitian is
helpful.
26
6
ePhpopT Neha;f;Fr; rj;JzT
cztUe;JtJ vd;gJ clYf;F czitAk;> tsHtjw;Fr; rj;Jg; nghUl;fisf;
nfhLg;gJk; kl;LNk my;y. mJ xU Mde;jkhd> r%f mDgtkhFk;.
ePhpopT NehahdJ cq;fs; ez;gHfs; kw;Wk; FLk;gj;Jld; cztUe;jp kfpo cq;fisj;
jLj;Jtplf; $lhJ. ePq;fs; ,g;NghJk; FLk;g> r%f> gs;sp kw;Wk; kj tpohf;fs;
Nghd;w rpwg;Gf; nfhz;lhl;lq;fis mDgtpf;fyhk;. cq;fs; czTf; fl;Lg;ghL epGzH>
ePhpopT Neha; fy;tpahsH kw;Wk; kUj;Jthplk; vd;d cz;zyhk;> vg;NghJ cz;zyhk;
vd;W Nfl;Lf;nfhs;Sq;fs;. cq;fs; czitAk;> ePhpopT Neha; kUe;JfisAk; cq;fs;
tho;f;ifKiwf;Fk;> rhjhuz FLk;g tof;fj;Jf;Fk; Vw;g khw;wpf;nfhs;s KbAk;.
,Ue;jNghjpYk;> cq;fs; ePhpopT Nehiaf; fl;Lg;ghl;Lf;Fs; itf;fTk;> cly; eyj;NjhL
,Uf;fTk;> cq;fs; czTg; gof;fq;fspy; khw;wq;fs; nra;a Ntz;bajpUf;fyhk;.
Vd; rj;JzT cz;ZtJ mtrpakhfpwJ?
rj;jhd czT> ePhpopT Neha; epHthfj;jpd; Kf;fpakhd gq;Ffspy; xd;whFk;.
ed;whf czT cl;nfhs;tJ> cq;fs; ,uj;j FSNfh]; (rHf;fiu) msTfs;> ,uj;jj;jpy;
nfhOg;G kw;Wk; ,uj;j mOj;jk; Nghd;wtw;iw epHtfpf;f cjTfpwJ. ed;whf czT
cl;nfhs;tJ MNuhf;fpakhd cly; viliaf; fl;Lf;Nfhg;ghf itj;jpUf;fTk; cjTfpwJ.
Njitf;F mjpfkhf cs;s vil cq;fs; ePhpopT Nehiaf; fl;Lg;gLj;jf; fbdkhf;fp
tpLfpwJ. MfNt cq;fs; mjpf viliaf; Fiwj;J> ePhpopT Neha; epHthfj;jpid Nkk;gLj;j
cjTtjw;Fr; rj;jhd czT mtrpakhfpwJ.
czTf; fl;Lg;ghL rk;ge;jg;gl;l ve;j MNyhridAk; cq;fs; Njitf;F Vw;g
tbtikf;fg;gl;bUf;f Ntz;baJ mtrpakhFk;. mr;rkaj;jpy;jhd; cq;fs; czTf;
fl;Lg;ghL epGzH cjtpfukhf ,Ug;ghH.
27
Healthy eating for diabetes - continued
What is healthy eating for diabetes?
Healthy eating for diabetes is the same as healthy eating for everyone. A healthy eating
pattern encourages:
• High fibre cereals including wholegrain breakfast cereals, wholemeal or grainy breads,
wholemeal pasta and brown rice
• Two serves of fruit and five or more serves of vegetables every day. Include legumes such as
baked beans, white beans, kidney beans, lentils, chickpeas and split peas
• One to two serves of lean meat, fish, skinless poultry or alternatives each day. Alternatives
include legumes, eggs, nuts and seeds
• Dairy foods (e.g. milk, cheese and yoghurt) that are low fat or skim are suitable for everyone
over the age of two
• Limit saturated fat (e.g. butter, cream and pastries)
• Have a low–moderate fat intake
• Avoid adding salt to food. Choose low salt or reduced salt foods. Limit salty foods such as
pickles, appalan and dry salted fish
• Eat only moderate amounts of sugars and limit or avoid foods high in added sugars (e.g.
sweets, chocolate and ice cream)
• Drink plenty of water
• If you drink alcohol, limit your intake to 2 standard drinks a day. It will also be a good idea
to include alcohol free days each week.
How can I keep my blood glucose (sugar) levels in the healthy range?
It is very important that people with diabetes aim to keep their blood glucose levels in target
range with regular physical activity, healthy eating and appropriate treatment (medications
and/or insulin if required). (Refer to Chapter 13 on Blood Glucose Monitoring.
You can help to do this by spreading your food intake out over the day, not overdoing your
serve sizes and choosing mostly high fibre, low fat and lower glycemic index carbohydrates.
Regular reviews with your dietitian are important to help you get the balance right between
your blood glucose levels, the food you eat, exercise and your diabetes medication, if you
take them. A dietitian may suggest you make changes to the types of food you eat and how
much you eat to help keep you healthy. Your dietitian will try to work within the foods and
cooking methods that you traditionally use.
28
ePhpopT Neha;f;Fr; rj;JzT - njhlUk;
ePhpopT Neha;f;Fj; Njitahd rj;JzTfs; vit?
ePhpopT Neha;f;Fj; Njitahd rj;JzT vd;gJ ehk; vy;NyhUk; rhg;gpLfpd;w rj;JzNt
MFk;. rj;JzTg; gof;fk; gpd;tUtdtw;iw cz;z Cf;Ftpf;fpwJ:
• KOj;jhdpa fhiy czTfs;> ckp ePf;fg;glhj NfhJik my;yJ jhdpa
nuhl;bfs;> ckp ePf;fg;glhj NfhJik gh];jh kw;Wk; gOg;G mhprp Nghd;w ehHr;rj;J
kpFe;j jhdpa tiffs;
• jpdKk; ,uz;L gq;F goq;fs; kw;Wk; Ie;J my;yJ mjw;F Nkw;gl;l gq;F fha;fwpfs;.
mj;Jld; NrHj;Jf; nfhs;s Ntz;bait> Ntfitj;j gPd;];> nts;is gPd;];> fpl;dp
gPd;];> gUg;G tiffs;> nfhz;ilf; fliy kw;Wk; cilj;j gl;lhzp Nghd;witahFk;
• jpdKk; xd;wpypUe;J ,uz;L gq;F nfhOg;G ePf;fg;gl;l ,iwr;rp> kPd;> Njhy; ePf;fg;gl;l
Nfhopf;fwp my;yJ mtw;Wf;F <lhditfs; - <lhdit vd;gjpy; mlq;Fgit gaW
tiffs;> Kl;ilfs;> nfhl;ilfs; kw;Wk; tpijfs; Nghd;witahFk;
• Fiwthd nfhOg;Gs;s my;yJ Mil ePf;fg;gl;l ghyhy; jahhpf;fg;gl;l czTfs;
(vLj;Jf;fhl;lhf> ghy;> ghyhilf;fl;b kw;Wk; NahfHl;) ,it ,uz;L taJf;F
Nkw;gl;l midtUf;Fk; jFjpahdit
• kpUff; nfhOg;ig msNthL gad;gLj;jTk; (vLj;Jf;fhl;lhf> ntz;nza;> ghyhil
kw;Wk; khTg; gz;lq;fs;)
• Fiwe;j-kpjkhd nfhOg;ig vLj;Jf; nfhs;sTk;
• czTf;F cg;Gr; NrHg;gijj; jtpHf;fTk;> Fiwe;j cg;G my;yJ Fiwf;fg;gl;l cg;G
czTfisj; NjHe;njLf;fTk;. CWfha;> mg;gsk; kw;Wk; cg;gpl;l fUthL Nghd;w
cg;G epiwe;j czTfisf; msNthL gad;gLj;jTk;
• ,dpg;G tiffis kpjkhd msT kl;LNk cz;zTk;. rHf;fiu mjpf
mstpy; NrHf;fg;gl;l czTfisf; Fiwf;fTk; my;yJ jtpHf;fTk;. (vLj;Jf;fhl;lhf>
kpl;lha;fs;> rhf;Nyl; kw;Wk; I];fphPk;)
• mjpf mstpy; jz;zPH FbAq;fs;
• ePq;fs; kJ mUe;Jgtuhf ,Ue;jhy;> ePq;fs; xU ehisf;F 2 epak msTld; Fbia
epWj;jpf; nfhs;Sq;fs;. xt;nthU thuj;jpYk; rpy ehl;fs; kJ mUe;jhky; ,Ug;gJ
mUikahd NahridahFk;.
ehd; vt;thW vd;Dila ,uj;j FSNfh]; (rHf;fiu) msTfis MNuhf;fpa
tiuaiwf;Fs; itj;jpUf;f KbAk;?
ePhpopT Neha; cs;s egHfs; jq;fSila ,uj;j FSNfh]; msTfis xOq;fhd cly;
nray;ghLfs;> rj;JzT kw;Wk; Njitahd rpfpr;ir (kUe;J tiffs; kw;Wk; my;yJ
Njitg;gl;lhy; ,d;Rypd;) ,itfspd; %yk; Fwpg;gpl;l ,yf;F tiuaiwf;Fs; itj;jpUg;gJ
kpfTk; mtrpakhFk;. (,uj;j FSNfhirf; fz;fhzpj;jy; vd;w jiyg;gpy; mj;jpahak; 13Ig; ghHf;fTk;)
ePq;fs; xU ehspy; cl;nfhs;Sk; czit me;j ehs; KOf;f rkkhfg; gphpj;J> rhg;gpLk;
msT $btplhjgb> ehHr;rj;J mjpfKs;s> nfhOg;G FiwthAs;s> Fiwe;j fpisnrkpf;
FwpaPL (glycemic index) cs;s fhHNghi`l;Nul; czTfisj; NjHe;njLg;gjd; %yk;
,jw;F ePq;fs; cjtp nra;a KbAk;.
czTf; fl;Lg;ghL epGzUld; nra;a Ntz;ba xOq;fhd kW Ma;T mtrpakhFk;. mJ
cq;fs; ,uj;j FSNfh]; msTfs;> ePq;fs; cz;Zfpd;w czT> clw;gapw;rp kw;Wk;
ePq;fs; vLj;Jf; nfhz;bUe;jhy;> ePhpopT Neha;f;fhd kUe;J tiffs; ,itfSf;Fs; xU
rkepiyia vl;l cq;fSf;F cjtpGhpAk;. cq;fis MNuhf;fpakhf itj;jpUf;f cjTk;
tifapy; vd;d tifahd czTfs; cz;z Ntz;Lk;> vt;tsT cz;z Ntz;Lk;
vd;gjpy; khw;wq;fis czTf; fl;Lg;ghL epGzH cq;fSf;F mwpTWj;jyhk;. ePq;fs;
ghuk;ghpakha;g; gad;gLj;Jk; czT kw;Wk; rikay; KiwfspNyNa cq;fs; czTf;
fl;Lg;ghL epGzH topelj;j Kaw;rpg;ghH.
29
7
What’s in food?
You may have heard about:
• Carbohydrates
• Fibre
• Protein
• Fat
• Vitamins and Minerals.
These are called nutrients and they help your body to work properly and stay healthy. A nutrient
is a substance found in food. You can find more information on each of these nutrients below.
Carbohydrates
Carbohydrates are the best energy source for your body. When they are eaten they
breakdown to form glucose in the bloodstream. Eating regular meals and spreading your
carbohydrate foods evenly over the day can help to maintain your energy levels without
causing blood glucose levels to go too high or too low.
Carbohydrate foods include:
• Breads and cereals (e.g. rice, idli (savory cake made from fermented rice and black lentils),
dosa (fermented crepe or pancake made from rice batter and black lentils) and uppuma
(breakfast food made from semolina))
• Milk and yoghurt (e.g. buttermilk and Thayir (yoghurt rice dish))
• Fruit (e.g. banana, melons and grapes)
• Starchy vegetables and legumes (e.g. cassava, potatoes, sweet potatoes, corn, lentils and
chick peas)
• Sugar and sugary foods (e.g. jaggery, honey, palm sugar, sweet biscuits and soft drinks).
Most of these foods, except sugar and sugary foods, also provide other important nutrients
to help keep you healthy. It is important to include these foods every day.
Eating a large serve of carbohydrate (e.g. a large plate of lentils or rice) may cause your blood
glucose levels to rise too high. Also, eating too much food all the time, even if it is healthy
food, will cause you to put on weight. Being overweight makes it harder to manage your
blood glucose levels.
As everyone is different, talk to your dietitian about the amount of carbohydrate food you
need to eat.
Sometimes testing your blood glucose level two hours after a meal can help you to work out
if you ate too much carbohydrate at a meal. If this happens a lot speak to your dietitian or
diabetes educator who can give you advice on what to do. Cutting down carbohydrates is
not always the answer.
Glycemic Index
All carbohydrate foods will breakdown to form glucose. Some carbohydrates break down to
glucose fast and some break down slowly. The Glycemic Index (GI) is a way of measuring how
fast or slow a carbohydrate food affects blood glucose levels.
Low glycemic index foods raise your blood glucose levels more slowly than high glycemic
index foods. Eating mostly low glycemic index foods may help people with diabetes to reduce
30
7
cztpy; vd;d cs;sJ?
gpd;tUgitfisg; gw;wp ePq;fs; Nfs;tpg;gl;bUf;ff;$Lk;:
• khTr;rj;J (Carbohydrates)
• ehHr;rj;J (Fibre)
• Gujr;rj;J (Protein)
• nfhOg;Gr;rj;J (Fat)
• itl;lkpd;fs; kw;Wk; cg;Gr;rj;Jf;fs; (Vitamins and Minerals).
,it Cl;lr;rj;Jf;fs; vd;W miof;fg;gLk;. cq;fs; cly; xOq;fhf Ntiy nra;aTk;>
MNuhf;fpakhf ,Uf;fTk; ,it cjTfpd;wd. Cl;lr;rj;J vd;gJ cq;fs; cztpy; cs;s
nghUshFk;. Xt;nthU Cl;lr;rj;J gw;wpa Nkyjpf tptuq;fis fPNo fhzyhk;.
khTr;rj;Jfs; (Carbohydrates)
khTr;rj;Jfs; cq;fs; clYf;Fj; Njitahd kpfr;rpwe;j Mjhur; rf;jpahFk;. cz;lgpd;
mit ,uj;j Xl;lj;jpy; FSNfhrhf khw;wg;gLfpd;wd. xOq;fhf czit cz;gJk;>
khTr;rj;Js;s czTfis ehs; KOtJk; rkkhfg; gq;fpl;L cz;gJk; ,uj;j FSNfh];
msTfs; kpff; $lNth> kpff; FiwaNth nra;ahky; cq;fs; rf;jp msitr; rkg;gLj;j
cjTfpd;wd.
khTr;rj;J czTfspy; gpd;tUtd mlq;Fk;:
• nuhl;b kw;Wk; jhdpaq;fs; (vLj;Jf;fhl;lhf> mhprp> ,l;yp (mhprp kw;Wk; cSe;J khTf;
fyitapypUe;J Gspf;f itj;Jr; nra;ag;gLk; gz;lk;)> Njhir (mhprp kw;Wk; cSe;J
khtpdhy; Gspf;f itj;Jr; nra;ag;gLk; mg;gk;) kw;Wk; cg;Gkh (uitapypUe;J
jahhpf;fg;gLk; fhiy czT))
• ghy; kw;Wk; NahfHl; (vLj;Jf;fhl;lhf> NkhH kw;Wk; japH (NahfHl; mhprp czT))
• goq;fs; (vLj;Jf;fhl;lhf> thiog;gok;> jhHg;G+rzp kw;Wk; jpuhl;ir)
• khTr;rj;Js;s fha;fwpfs; kw;Wk; gaW tiffs; (vLj;Jf;fhl;lhf> kur;rd
P pf; fpoq;F>
cUisf;fpoq;F> rHf;fiuts;spf; fpoq;F> Nrhsk;> gUg;G tiffs; kw;Wk; nfhz;ilf; fliy)
• ,dpg;G kw;Wk; ,dpg;Gg; gz;lq;fs; (vLj;Jf;fhl;lhf> nty;yk;> Njd;> gdQ;rHf;fiu>
,dpg;G gp];fl; kw;Wk; nkd; ghdq;fs;).
,e;j czT tiffspy;> ,dpg;G kw;Wk; ,dpg;Gg; gz;lq;fisj; jtpHj;J> ngUk;ghyhdit
ePq;fs; MNuhf;fpakhf ,Uf;f cjTk; tifapy;> kw;w Kf;fpakhd Cl;lr;rj;Jf;fisAk;
mspf;fpd;wd. ,t;tif czTg; nghUl;fis xt;nthU ehSk; NrHj;Jf; nfhs;tJ
mtrpakhFk;.
mjpf msT khTr;rj;Jg; nghUl;fis (vLj;Jf;fhl;lhf> xU nghpa jl;L epiwa gUg;G
tiffs; my;yJ mhprp) cz;ZtJ cq;fs; ,uj;j FSNfh]; msTfs; mjpf msT
caHtjw;Ff; fhuzkha; ,Uf;fyhk;. mj;Jld;> vy;yh Neuq;fspYk; mjpf msT czT
vLj;Jf; nfhs;tJ> mJ rj;;jhd czthapUe;j NghjpYk;> cq;fs; viliaf; $l;Lk;. cly;
mjpf gUkdhapUe;jhy;> cq;fs; ,uj;j FSNfh]; msTfisr; rkhspg;gJ fbdkhfp
tplf;$Lk;.
MSf;F Ms; tpj;jpahrk; ,Ug;gjhy;> cq;fs; czTf; fl;Lg;ghL epGzhplk; ePq;fs;
cz;zj; Njitahd khTr;rj;J czitg; gw;wpg; NgRq;fs;.
rpy Neuq;fspy;> czT cz;L ,uz;L kzpNeuq;fSf;Fg; gpwF cq;fs; ,uj;j FSNfh];
msitr; Nrhjpg;gJ> czTld; mjpf msT khTr;rj;ij ePq;fs; cz;bUf;fpwPfsh
vd;gijf; fzf;fpl cjTfpwJ. ,J gyKiw NeHe;jhy;> cq;fs; czTf; fl;Lg;ghL
epGzhplk; my;yJ ePhpopT Neha;f; fy;tpahshplk; NgRq;fs;. mtHfs; vd;d nra;tnjd;W
vd;W cq;fSf;F MNyhrid toq;FthH. khTr;rj;ij epWj;JtJ kl;LNk vg;NghJk; ,jw;F
tpilay;y.
fpisnrkpf; FwpaPL (Glycemic Index) (GI)
vy;yh tif khTg;nghUs; czTfSk; cilf;fg;gl;L FSNfhrhf khWfpd;wd. rpy
khTg;nghUl;fs; FSNfhrhf cilgLtJ NtfkhfTk;> rpy nkJthfTk; eilngWk;.
fpisnrkpf; FwpaPL (Glycemic Index) (GI) vd;gJ khTg;nghUs; czTfs; vt;tsT Ntfkhf
my;yJ nkJthf ,uj;j FSNfh]; msTfisg; ghjpf;fpwJ vd;gij msf;Fk; topahFk;.
31
What’s in food? - continued
average blood glucose levels, lower blood fats and raise healthy cholesterol. They may also
help you feel fuller for longer which may help with weight control. It is still important to not
overdo your serve sizes.
Not all low glycemic index foods are healthy. You still need to consider if the food fits into the
healthy eating recommendations listed earlier. Try to eat mostly high fibre low fat and lower
glycemic index foods. Including a lower glycemic index food at every meal is a good start.
Some healthy low glycemic index foods include legumes (lentils, dried beans and dried peas),
pasta, wholegrain cereals (oats), sweet corn, low fat milk and yoghurt, most fruit and many
high fibre grainy breads.
Rice is usually a high glycemic index food. However, there are some varieties of rice that have
a lower glycemic index. These include parboiled rice, Basmati rice and Doongara rice.
What about sugar?
Sugar is also a carbohydrate. Eating small amounts of sugar will not affect your diabetes, e.g.
1 teaspoon of sugar in your cup of tea or a thin spread of jam on your toast.
Some foods that contain sugar are also healthy foods. For example fruit and milk naturally
contain sugar. Other healthy foods have had small amounts of sugar added to them (e.g.
some high fibre breakfast cereals and yoghurts). We know these foods are good for us so we
can include them in our diet.
However eating or drinking large amounts of foods that are very high in sugar (e.g.Payasam
(rice or wheat dessert), Laddoo (ball-shaped sweets), mysore pak (sweet dessert made from
ghee and chick pea flour)) can cause your blood glucose levels to rise too high. They can also
cause you to put on weight. These foods are best eaten in small amounts. Choose diet soft
drinks and cordials instead of standard varieties.
If you are using sugar in recipes, think about how much sugar you will end up eating. If the
recipe is very high in sugar and you will be having a large serve, try reducing the amount of
sugar, have a smaller serve or replace some of the sugar with an alternative sweetener. Try to
choose recipes that are low in fat (particularly saturated fat) and contain some fibre
Fibre
Fibre is important for everyone, including people with diabetes. Fibre can help keep your
digestive system healthy and prevent constipation.
Fibre is also very useful for people with diabetes. It can help to lower “bad” cholesterol which
helps to keep your heart healthy. Also many foods that are high in fibre have a low glycemic
index. This is because some types of fibre can slow down digestion of the food. Eating foods
high in fibre can also keep you feeling fuller for longer so may help with weight control.
High fibre foods include whole fruits (not juice), vegetables, legumes, nuts and seeds, grainy
and wholemeal breads, high fibre cereals, Sambhar (spicy lentil dish) and kootu (vegetable
and lentil dish).
Fat
Fat is an essential nutrient. However many of us eat too much fat or eat the wrong types of fat.
Fat is high in kilojoules. Eating too much fat can cause you to put on weight or make it harder
for you to lose weight.
Some fats (saturated fats and trans fats) can increase your risk of heart disease and make it
32
cztpy; vd;d cs;sJ - njhlUk;
Fiwe;j fpisnrkpf; FwpaPL cs;s czTfs;> caHe;j fpisnrkpf; FwpaPL
cs;s czTfis tpl cq;fs; ,uj;j FSNfh]; msTfis kpf nkJthfNt
$l;Lfpd;wd. ngUk;ghYk; Fiwe;j fpisnrkpf; FwpaPL cs;s czTfs;> ePhpopT
Neha; cs;stHfSf;F ruhrhp ,uj;j FSNfh]; msTfisf; Fiwf;fTk;> ,uj;jf;
nfhOg;igf; Fiwf;fTk;> ey;y nfhOg;ig mjpfhpf;fTk; cjTfpd;wd. mit ePqf
; s;
tapW epiwa rhg;gpl;l czHit ePzl
; Neuj;Jf;F Vw;gLj;jp> cq;fs; viliaf;
fl;Lg;gLj;j cjTfpd;wd. Mdhy; ePqf
; s; vLj;Jf;nfhs;Sk; mstpidf; $l;lhky;
,Ug;gJ mtrpakhFk;.
vy;yh Fiwe;j fpisnrkpf; FwpaPL cs;s czTfSk; rj;jhdit my;y. me;j
czT Kd;dNk nfhLf;fg;gl;bUf;Fk; rj;JzTg; ghpe;Jiuj;jYf;F Vw;g cs;sdth
vd;gij ePqf
; s; fUj;jpy; nfhs;tJ mtrpakhFk;. ngUk;ghYk; mjpf ehHr;rj;J
;
cs;s> Fiwe;j nfhOg;G cs;s kw;Wk; Fiwe;j fpisnrkpf; FwpaPL cs;s
czTfis cz;z Kaw;rpf;f Ntz;Lk;. Fiwe;j fpisnrkpf; FwpaPL cs;s
czTfis xt;nthU Kiw rhg;ghl;bYk; NrHj;Jf; nfhs;tJ xU ey;y Muk;gkhFk;.
Fiwe;j fpisnrkpf; FwpaPL cs;s rpy czTfspy; gaW tiffs; (gUg;G>
cyHe;j gPd]
; ; kw;Wk; cyHe;j gl;lhzp tiffs;)> gh];jh KO jhdpaq;fs; (Xl;]); >
,dpg;Gr; Nrhsk;> Fiwe;j nfhOg;Gs;s ghy; kw;Wk; NahfHl;> ngUk;ghyhd goq;fs;
kw;Wk; mjpf ehHr;r
; j;J
; s;s jhdpa nuhl;bfs; Mfpait mlq;Fk;.
mhprp nghJthf xU mjpf fpisnrkpf; FwpaPL cs;s czT. ,Ug;gpDk; rpy
Fiwe;j fpisnrkpf; FwpaPL cs;s mhprp tiffSk; cz;L. mjpy; GOq;fy; mhprp>
ghRkjp mhprp (Basmati) kw;Wk; J}d;fuh mhprp (Doongara) Nghd;wit mlq;Fk;.
rHf;fiu gw;wpa tptuk; vd;d?
rHf;fiuAk;$l xU khTr;rj;Jjhd;. Fiwe;j mstpy; rHf;fiu cz;gJ cq;fs;
ePhpopT Nehiag; ghjpf;fhJ. vLj;Jf;fhl;lhf> xU Nfhg;ig NjePhpy; 1 Njf;fuz;b
rHf;fiu my;yJ thl;ba nuhl;bapy;; nky;ypajhfj; jltg;gl;l [hk; Mfpait.
rHf;fiu cs;s rpy czTfs; rj;JzTfshfTk; ,Uf;fpd;wd. vLj;Jf;fhl;lhf>
goKk;> ghYk; ,aw;ifapNyNa rHf;fiuiaf; nfhz;Ls;sd. kw;w MNuhf;fpa
czTfs; rpW msT rHf;fiuiaf; nfhz;Ls;sd. (vLj;Jf;fhl;lhf> rpy mjpf
ehHr;rj;Js;s fhiy czT jhdpaq;fs; kw;Wk; NahfHl;). ,e;j czTfs; ekf;F
ed;ik gag;gd vd;gJ ekf;nfy;yhk; njhpAk;. MfNt mitfis ekJ cztpy;
NrHj;Jf; nfhs;syhk;.
,Ug;gpDk;> rHf;fiu kpf mjpfk; cs;s czTfisg; ngUkstpy; cz;gNjh>
mUe;JtNjh (vLj;Jf;fhl;lhf> ghahrk; (mhprp my;yJ NfhJikahy; nra;ag;gl;l
,dpg;Gg; gz;lk;)> yl;L (ge;J tbtpyhd ,dpg;G tif)> ik#HghF (nea; kw;Wk;
fliy khtpdhy; jahhpf;fg;gLk; ,dpg;Gg; gz;lk;) cq;fs; ,uj;j FSNfh];
msTfis ngUkstpy; caHj;jptpLk;. mit cq;fs; viliaAk; $l;btpLk;. ,e;j
czTfis rpwpa mstpy; cz;ZtNj ey;yJ. nghJthd ghd tiffistpl>
gj;jpa (diet) nkd;ghdq;fisAk;> fhHbay;fisAk; NjHe;njLq;fs;.
rikay; Fwpg;gpy; ePq;fs; rHf;fiuiag; gad;gLj;Jk;NghJ> ,Wjpapy; ePq;fs;
vt;tsT rHf;fiuiar; rhg;gplg; NghfpwPHfs; vd;gijAk; fUj;jpy;; nfhs;Sq;fs;.
rikay; Fwpg;gpy; kpf mjpf mstpy; rHf;fiu ,Ue;jhy;> rpwpjsT rHf;fiuiaf;
Fiwj;Jf; nfhs;Sq;fs; my;yJ czit rpwpa mstpy; vLj;Jf; nfhs;Sq;fs;
my;yJ rHf;fiuf;Fg; gjpyhf nraw;if ,dpg;igr; NrHj;Jf; nfhs;Sq;fs;. nfhOg;G
Fiwthf cs;sJk; (Fwpg;ghf kpUff; nfhOg;G) nfhQ;rk; ehHr;rj;J cs;sJkhd
rikay; Fwpg;igj; NjHe;njLj;Jf; nfhs;Sq;fs;.
33
harder to manage your diabetes. Avoid these types of fats (e.g. ghee, coconut oil, full fat dairy
foods, fatty meats and fried foods).
Polyunsaturated fats (e.g. oily fish, safflower and sunflower oils) and monounsaturated fats
(e.g. avocado, canola and olive oils) can help reduce your risk of heart disease. They are better
choices than saturated fat. Both of these fats have benefits for your health so vary between
them. These fats are still high in kilojoules, so if you are overweight, eat them in moderation.
To help you get the right type of fat and avoid eating too much fat;
Choose:
• Meat trimmed of fat
• Chicken trimmed of fat and skin
• Low fat cooking methods such as barbequing, grilling, dry frying, baking, steaming or
poaching
• To cook stuffed vegetable dishes by grilling instead of high fat baking or frying
• Low fat dairy foods
• To choose from the low fat cheddar cheese, ricotta,
paneer, cottage or quark cheese
• To eat more fish including oily fish (e.g. tuna, salmon,
mackerel, herring, sardines)
• Olive, canola, sesame, peanut, corn, safflower or
sunflower oils for cooking, marinades and dressing
• Margarines made from olive, canola, safflower or
sunflower oils
• Alternatively, use a plant sterol enriched margarine (i.e. Proactive™ and Logicol™ ), but
speak to your dietitian and/or doctor about it before you decide to use it
• To include small amounts of avocado, unsalted nuts and seeds in your diet.
Limit/avoid:
• Fatty or processed meats (e.g. untrimmed meat, salami and bacons)
• High fat cooking methods such as frying or roasting in fat
• Full fat dairy foods
• Butter, ghee, lard, vegetable shortening, tallow, cream, coconut oil, coconut milk and
coconut cream
• Heavily buttered bread
• Fried foods (e.g. fried fish, bajji (fried vegetables), murrukku (a savoury snack)), cakes (e.g.
Vada (doughnuts)), pastries, biscuits, crisps (e.g. Appalam (fried spiced lentil crisps)) and
high fat crackers
• Fried sweets
• Curry dishes cooked with butter, ghee or tallow.
Protein
Protein is essential to your body everyday to repair old or damaged parts. Most people living
in Australia already eat enough protein and do not need to eat more.
Choose protein foods that are also low in fat. Foods that are a good source of low fat protein
are lean meat, poultry without the skin, fish and seafood, eggs, low fat dairy products,
unsalted nuts, legumes (dried beans, dried peas and lentils) and soy products such as tofu.
Speak to your dietitian if you are not sure if you are eating enough protein.
34
ehHr;rj;J (Fibre)
ehHr;rj;J> ePhpopT NehAs;stHfs; cl;gl midtUf;Fk; mtrpakhdjhFk;. ehHr;rj;J
cq;fs; [Puz kz;lyj;ij MNuhf;fpakhf itj;Jf; nfhs;sTk;> kyr;rpf;fiyj; jLf;fTk;
cjTfpwJ.
ehHr;rj;J ePhpopT Neha; cs;stHfSf;F kpfTk; cjTfpwJ. mJ “nfl;l” nfhOg;igf;
Fiwj;J cq;fs; ,jaj;ij MNuhf;fpakhf itj;jpUf;f cjTfpwJ. mj;Jld; ehHr;rj;J
mjpfKs;s gy czTfspy; Fiwe;j fpisnrkpf; FwpaPL cs;sJ. Vndd;why; rpytif
ehHr;rj;Jf;fs; czT nrhpkhdk; Mtij jhkjg;gLj;JfpwJ. ehHr;rj;J mjpfKs;s czT
tiffis cz;Zk;NghJ> ePq;fs; tapW epiwa rhg;gpl;l czHit Vw;gLj;jp cq;fs;
viliaf; fl;Lg;gLj;j cjTfpwJ.
ehHr;rj;J mjpfKs;s czTfspy; KOg;goq;fs; (gor;rhW my;y)> fha;fwpfs;> gaW
tiffs;> nfhl;ilfs; kw;Wk; tpijfs;> jhdpa kw;Wk; ckp ePf;fg;glhj NfhJik
nuhl;bfs;> ehHr;rj;J kpFe;j jhdpatiffs;> rhk;ghH (gUg;G krhyh Fok;G) kw;Wk; $l;L
(fha;fwp kw;Wk; gUg;Gf; fwptiffs;) mlq;Fk;.
nfhOg;G (Fat)
nfhOg;G xU Kf;fpa Cl;lr;rj;jhFk;. ,Ug;gpDk; ek;kpy; gyH mjpf mstpyhd
nfhOg;igNah my;yJ jtwhd nfhOg;G tiffisNah cz;ZfpNwhk;.
nfhOg;G mjpf vhprf;jp (kilojoules) nfhz;lJ. mjpf mstpy; nfhOg;Gs;s czit
cz;ZtJ cq;fs; vilia mjpfhpf;fr; nra;Ak; my;yJ viliaf; Fiwg;gijf;
fbdkhf;fp tpLk;.
rpytiff; nfhOg;Gfs; (kpUff; nfhOg;Gfs; kw;Wk; XusT nfl;b kpUff; nfhOg;Gfs;) ,ja
Neha;ff
; hd mghaj;ij mjpfhpf;fr; nra;ayhk;. ,j;jifa
nfhOg;G tiffisj; jtpHf;fTk; (vLj;Jf;fhl;lhf>
nea;> Njq;fha; vz;nza;> KOf;nfhOg;G mlq;fpa
ghy;tifapdhy; jahhpf;fg;gl;l czTfs;> nfhOg;Gs;s
,iwr;rpfs; kw;Wk; vz;nzapy; nghhpf;fg;gl;l czTfs;).
Polyunsaturated fat vdg;gLk; xUtif nkd;ikahd
jhtuf; nfhOg;Gfs; (vLj;Jf;fhl;lhf> vz;nza;r; rj;J
; s;s
kPdf
; s;> #hpafhe;jp vz;nza;> Frk;gg;G+ vz;nza;) kw;Wk;
monounsaturated fats vdg;gLk; xUtif kpf nkd;ikahd
jhtuf; nfhOg;Gfs; (vLj;Jf;fhl;lhf> mtfhNlh vz;nza;> fLF vz;nza; kw;Wk;
Mypt; vz;nza;) ,ja Neha;ff
; hd mghaj;ijf; Fiwf;fr; nra;a KbAk;. ,it kpUff;
nfhOg;igj; NjHe;njLg;gij tpl ey;yjhFk;. ,e;j ,uz;Ltif nfhOg;GfSk; cq;fs;
cly;eyj;Jf;F ed;ik Ghpfpd;wd. MfNt khwp khwp cgNahfpf;fTk;. ,Ug;gpDk; ,t;tiff;
; s; cly; gUkdhdtuhf
nfhOg;Gfspy; mjpf vhprf;jp (kilojoules) cs;sd. MfNt ePqf
,Ue;jhy;> mitfis kpjkhd mstpy; cl;nfhs;sTk;.
rhpahd tiff; nfhOg;ig vLj;Jf; nfhs;s kw;Wk; mjpf mstpy; nfhOg;ig
cz;Ztijj; jtpHf;f cjTk; tifapy;>
gpd;tUtdtw;iwj; NjHe;njLf;fTk;:
• nfhOg;G ePf;fg;gl;;l ,iwr;rp
• nfhOg;Gk;> NjhYk; ePf;fg;gl;l Nfhop
• ghHgf;A+ nghhpg;gJ> fk;gpfspy; thl;LtJ> vz;nzapd;wp tWg;gJ> RLtJ> mtpg;gJ
my;yJ Ntfitg;gJ Nghd;w Fiwe;j nfhOg;G tifapyhd rikay; nra;tJ
• caH nfhOg;gpy; nghhpg;gJ my;yJ tWg;gJ ,y;yhky; fk;gpfspy; thl;Lk; tifapy;>
fha;fwp jpzpf;fg;gl;l rikay; gz;lq;fisr; rikay; nra;tJ
• nfhOg;G Fiwe;j tifapdhy; jahhpf;fg;gl;l czTfs;
• nfhOg;G Fiwe;j nrlhH ghyhilf;fl;b> hpNfhl;lh ghyhilf;fl;b> gdPH> fhl;Nl[;
my;yJ f;thHf; ghyhilf;fl;b
• vz;nza; rj;Js;s kPd;fs; cl;gl;l epiwa kPd;fis cz;Zjy; (vLj;Jf;fhl;lhf>
l;A+dh> rhy;kd;> nkf;fuy;> n`hpq;> rhHbd;)
35
Vitamins and minerals
Vitamins and minerals are important for a healthy body. Eating a wide variety of foods from
all five food groups will help you get all the vitamins and minerals your body needs.
The food groups are:
• Breads and cereals
• Vegetables
• Fruit
• Dairy foods
• Meat or meat alternatives (e.g. poultry, seafood, eggs, tofu, legumes, nuts and seeds).
36
•
•
•
•
rikaYf;Fk;> ,iwr;rpia Cwitg;gjw;Fk;> fha;fwpia bu];]pq; nra;tjw;Fk;
Mypt;> fLF> vs;> epyf;fliy> Nrhsk;> Frk;gg;G+ my;yJ #hpafhe;jp
Nghd;witfspd; vz;nza;fs;
Mypt;> fLF> Frk;gg;G+ my;yJ #hpafhe;jp Nghd;witfsplkpUe;J jahhpf;fg;gLk;
nraw;if ntz;nza; (Margarines)
mjw;Fg; gjpyhf jhtu ];Buhy; (sterol) epiwe;j nraw;if ntz;nza; (Margarine)
(vLj;Jf;fhl;lhf> GNuhMf;bt; (Proactive™) kw;Wk; yh[pfhy; (Logicol™)) gad;gLj;jTk;.
Mdhy; ePq;fs; mijg; gad;gLj;j KbTnra;Ak; Kd;dhy;> cq;fs; czTf; fl;Lg;ghL
epGzH kw;Wk; / my;yJ kUj;Jthplk; NgRq;fs;
cq;fs; cztpy; rpW mstpy; mtfhNlh (avocado)> cg;Gg; Nghlhj nfhl;ilfs;
kw;Wk; tpijfisr; NrHj;Jf; nfhs;sTk;.
jtpHf;f Ntz;bait / msTld; gad;gLj;j Ntz;bait:
•
•
nfhOg;G epiwe;j my;yJ gjg;gLj;jg;gl;l ,iwr;rp (vLj;Jf;fhl;lhf> chpf;fg;glhj
,iwr;rp> ryhkp kw;Wk; gd;wp ,iwr;rp)
vz;nzapy; nghhpj;jy; my;yJ tWj;jy; Nghd;w mjpff; nfhOg;G cs;s tifapyhd
rikay; nra;tJ
•
KOf;nfhOg;G mlq;fpa ghy;tifapdhy; jahhpf;fg;gl;l czTfs;
•
ntz;nza;> nea;> gd;wpf;nfhOg;G> jhtuf;nfhOg;G> kpUff;nfhOg;G> ghyhil> Njq;fha;
vz;nza; kw;Wk; Njq;fha; fphPk;
•
mjpfkhf ntz;nza; jltg;gl;l nuhl;b
•
vz;nzapy; nghhpf;fg;gl;l czTfs; (vLj;Jf;fhl;lhf> kPd; nghhpay;> g[;[p (fha;fwpg;
nghhpay;)> KWf;F (fhukhd jpd;gz;lk;)> Nff;Ffs; (vLj;Jf;fhl;lhf> til (krhyh
gzpahuk;)> khTg;gz;lq;fs;> gp];fl;> KWfy;fs; (vLj;Jf;fhl;lhf> mg;gsk; (gUg;G
krhyhtpy; nghhpj;j gz;lk;)) kw;Wk; mjpff; nfhOg;Gs;s nuhl;bfs;
•
tWj;j ,dpg;Gg; gz;lq;fs;
•
ntz;nza;> nea; my;yJ kpUff;nfhOg;gpy; rikay; nra;ag;gl;l fwp tiffs;.
Gujr;rj;;J (Protein)
Gujr;rj;J xt;nthU ehSk; cq;fs; clypd; gioa my;yJ NrjKw;w gFjpfisg;
gOJghHf;fj; Njitg;gLfpwJ. M];jpNuypahtpy; trpf;Fk; mNefH Njitahd msT
Gujj;ij cz;gjhy; NkYk; mjpfkhf cz;zj; Njitapy;iy.
nfhOg;Gf; FiwthAs;s Gujr;rj;Jf;fisNa NjHe;njLf;fTk;. nfhOg;G ePf;fg;gl;l ,iwr;rp>
Njhy; ,y;yhj Nfhopf;fwp> kPd; kw;Wk; fly; czT> Kl;il> Fiwe;j nfhOg;Gs;s ghypy;
jahhpf;fg;gl;l nghUl;fs;> cg;Gg; Nghlhj nfhl;ilfs;> gaW tiffs; (fhaitf;fg;gl;l
gPd;];> fhaitf;fg;gl;l gl;lhzp kw;Wk; gUg;Gfs;) kw;Wk; NlhG (tofu) Nghd;w Nrhahtpy;
jahhpf;fg;gl;l nghUl;fs; Nghd;wit Fiwe;j nfhOg;Gs;s Gujk; cs;s czTfshFk;
ePq;fs; Njitahd msT Gujr;rj;ijr; rhg;gpLfpwPHfsh vd;gJ cq;fSf;F cWjpahfj;
njhpatpy;iynad;why;> cq;fs; czTf; fl;Lg;ghL epGzhplk; NfSq;fs;.
itl;lkpd;fs; kw;Wk; cg;Gr;rj;Jf;fs; (Vitamins and minerals)
itl;lkpd;fs; kw;Wk; cg;Gr;rj;Jf;fs; MNuhf;fpakhd clYf;F mtrpakhFk;. ,e;j
vy;yh Ie;J czT tiffspypUe;Jk; gy tifahd czTfis cz;Ztjhy;> cq;fs;
clYf;Fj; Njitahd vy;yh itl;lkpd;fSk;> cg;Gr;rj;Jf;fSk; fpilf;f cjTfpd;wd.
me;j czT tiffs; gpd;tUkhW:
• nuhl;b kw;Wk; jhdpa tiffs;
•fha;fwpfs;
•goq;fs;
• ghypy; jahhpf;fg;gLk; czTfs;
• ,iwr;rp my;yJ ,iwr;rpf;F khw;W czTfs; (Nfhop> fly; czT> Kl;il> gaW
tiffs;> nfhl;ilfs; kw;Wk; tpijfs;).
37
8
Common Questions about Food and
Diabetes
How often should people with diabetes eat?
It is important for all people with diabetes to eat regular meals over the day. This helps to
spread food intake out and prevent blood glucose levels going too high or low.
Some people with diabetes take tablets or insulin to help manage their diabetes. These
medications may mean that you need to eat at certain times, eat a small snack between
meals or have a snack before bed. Discuss with your dietitian, diabetes educator or doctor
whether you need to eat at certain times or need to eat snacks.
If you eat at irregular hours (or you do shift work) it is important to discuss this with your
dietitian, diabetes educator or doctor as your medications may need to be adjusted to fit in
with when you are able to eat. It is important that you do your best to have a regular eating
pattern from day to day.
Why is it important to manage my weight?
Being overweight can make it harder to control your blood glucose levels. Carrying too much
fat around your middle is especially bad for diabetes and heart disease. If you are overweight,
ask your dietitian for advice on how to adjust your food intake to lose weight. Also speak to
your doctor or an exercise physiologist about exercise.
Can I eat fruit? What type of fruit can I eat and how much?
Yes, people with diabetes can eat fruit. Fruit is an excellent source of fibre, vitamins and
minerals. All fruit can be included as part of a healthy diet for people with diabetes. Fruit
contains natural sugar therefore it is important to spread fruit over the day.
The recommendation for fruit is the same as the general population. That is, two servings of
fruit each day. 1 serve of fruit equals:
•
•
•
•
•
•
•
1 medium piece of fruit (e.g. 1 apple or 1 orange or 1 pear)
2 smaller pieces of fruit (e.g. 2 plums or 2 kiwifruit)
1 cup chopped or canned fruit (not in syrup)
20 grapes
1 large peach
1 tablespoon of sultanas or 4 dried apricots*
1 small banana or ½ large banana.
Fruit juice is high in kilojoules and does not contain fibre. It is much better to eat the whole
fruit rather than drink the juice. Drinking too much juice raises blood glucose levels and may
contribute to weight gain. If you must drink juice, limit to a maximum of 1 small glass a day.
*Dried fruit contains a lot of natural sugar. If you eat dried fruit limit to a small quantity e.g. 1
tablespoon of sultanas, 2 dried figs or 4 pitted dates.
Can I eat unlimited vegetables?
Vegetables provide an excellent source of fibre, vitamins and minerals. Recommendations for
vegetables are five or more servings a day. One serve of vegetables is equal to ½ cup cooked
vegetables or 1 cup salad or 1 medium potato* or ½ cup cooked legumes*. Most vegetables
have very little impact on blood glucose levels and weight (i.e. salads, eggplants and
38
8
czT kw;Wk; ePhpopT Neha; gw;wpa
nghJthd Nfs;tpfs;
ePhpopT Neha; cs;stHfs; vj;jid Kiw rhg;gpl Ntz;Lk;?
ePhpopT Neha; cs;s vy;NyhUk; ehs; Kof;f xOq;fhfr; rhg;ghl;il
vLj;Jf;nfhs;tJ mtrpakhFk;. ,jdhy; cl;nfhs;Sk; czT rkkhfg; gq;fplg;gl;L>
,uj;j FSNfh]; msTfs; mjpfkhff; $LtijNah FiwtijNah jLf;f
cjTfpwJ.
ePhpopT Neha; cs;s rpyH jq;fSila ePhpopT Nehia epHtfpf;f cjTk; tifapy;
khj;jpiufisNah> ,d;RypidNah vLj;Jf;nfhs;fpd;wdH. ,e;j kUe;Jfis
vLf;Fk;NghJ ePq;fs; rpy Neuq;fspy; rhg;ghl;Lf;fpilapy; rpw;Wz;b vLj;Jf;
nfhs;Sjy;; my;yJ gLf;iff;Fr; nry;YKd; rpw;Wz;b vLj;Jf; nfhs;Sjy; Nghd;W
rhg;gpl Ntz;bajpUf;Fk;. ePq;fs; rpy Ntisfspy;jhd; rhg;gpl Ntz;bajpUf;Fkh
my;yJ rpw;Wz;bjhd; vLj;Jf; nfhs;s Ntz;bajpUf;Fkh vd;gij cq;fs;
czTf; fl;Lg;ghL epGzH> ePhpopT Neha;f; fy;tpahsH my;yJ kUj;Jthplk;
fye;JiuahLq;fs;.
ePq;fs; Neu xOq;fpy;yhky; czT cz;Zgtuhf ,Ue;jhy; (my;yJ ePq;fs; ~pg;l;
Ntiyapy; ,Ue;jhy;) ,ijg;gw;wp cq;fs; czTf; fl;Lg;ghL epGzH> ePhpopT Neha;f;
fy;tpahsH my;yJ kUj;Jthplk; fye;JiuahLtJ mtrpak;. Vndd;;why; ePq;fs;
vg;NghJ cz;zKbAk; vd;gijg; nghWj;J cq;fs; kUe;J vLj;Jf;nfhs;tijr;
rhpg;gLj;jpf; nfhs;s Ntz;bajpUf;Fk;. xt;nthU ehSk; xOq;fhf cz;Zk;
gof;fj;ij Kbe;j msT filg;gpbf;f Kaw;rpg;gJ mtrpakhFk;.
vd;Dila viliag; ghHj;Jf;nfhs;s Ntz;baJ Vd; mtrpakhfpwJ?
cly; mjpf gUkdhapUe;jhy; cq;fs; ,uj;j FSNfh]; msTfisr; rkhspg;gJ
fbdkhfp tplf;$Lk;. cq;fs; ,Lg;igr; Rw;wp mjpff; nfhOg;igr; Rke;jpUg;gJ
ePhpopT Neha;f;Fk;> ,ja Neha;f;Fk; ey;yjy;y. ePq;fs; mjpf gUkdhapUe;jhy;>
cly; viliaf; Fiwf;f czT vLj;Jf;nfhs;tij vg;gb rhpnra;J nfhs;tJ
vd;gij cq;fs; czTf; fl;Lg;ghL epGzhplk; MNyhrid NfSq;fs;.
mj;Jld; cly;gapw;rpiag; gw;wp cq;fs; kUj;JthplNkh my;yJ clw;gapw;rp
clypayhshplNkh ciuahLq;fs;.
ehd; goq;fs; rhg;gplyhkh? vt;tifahd goq;fs; ehd; rhg;gplyhk; mj;Jld;
vt;tsT rhg;gplyhk;?
Mk;> ePhpopT Neha; cs;stHfs; goq;fisr; rhg;gplyhk;. goj;jpy; ehHr;rj;J>
itl;lkpd;fs; kw;Wk; cg;Gr;rj;Jf;fs; epiwa cs;sd. ePhpopT Neha;
cs;stHfSf;F MNuhf;fpa cztpd; xU gFjpahf vy;yhg; goq;fisAk;
NrHf;fyhk;. goj;jpy; ,aw;ifahd rHf;fiu cs;sjhy; goq;fis ehs; KOtJk;
rkkhfg; gq;fpl;L cz;gJ mtrpakhFk;.
gok; rhg;gpLtjw;fhd ghpe;Jiufs; kw;wtHfSf;F vg;gbNah mNjNghy;jhd; mjpy;
khw;wkpy;iy. mjhtJ xt;nthU ehSk; ,uz;L gq;Ffs; Njit. 1 gq;F gok; vd;gJ:
•
•
•
•
•
1 eLj;jug; goj;Jz;L (vLj;Jf;fhl;lhf> 1 Mg;gps; my;yJ 1 MuQ;R my;yJ
1 Nghpf;fha;)
2 rpW goj;Jz;Lfs; (vLj;Jf;fhl;lhf> 2 gpsk;fs; my;yJ 2 fptp goq;fs;)
1 Nfhg;ig (eWf;fg;gl;l my;yJ jfulg;ghtpy; milf;fg;gl;l gok;)
(gor;rhw;wpy; Cwpajy;y)
20 jpuhl;irg; goq;fs;
1 nghpa gPr; (peach)
39
Common questions about food and diabetes - continued
artichokes). These vegetables are referred to as free foods and can be included in unlimited
quantities.
*Starchy vegetables (that is, potato, sweet potato, corn and legumes) do contain
carbohydrate. This means they are broken down into glucose to provide the body with
energy. Starchy vegetables can be included as part of a healthy eating plan in moderate
amounts to help manage blood glucose levels.
Are “diet” foods suitable?
Not all diet foods or foods marked “suitable for people with diabetes” are useful for people
with diabetes. Often they can be quite high in kilojoules or may have a lot of fat in them. Also
they can often be quite expensive.
Diet foods that you should avoid are:
• Diabetic chocolate. These are usually high in fat.
• Diet or low carbohydrate beer. These beers are still high in alcohol. It is the alcohol that is
more of a problem than the carbohydrate content.
Some diet foods are fine for people with diabetes. These are foods that normally may be
high in added sugar. Replacing the sugar with a sweetener such as Equal™, Splenda™ and
Sugarine ™ means you do not have to worry that they will raise your blood glucose level too
high. These include:
• Diet soft drinks
• Diet cordials
• Diet jellies.
What foods can I eat if I am always hungry?
If you are often hungry, make sure you are not overly restricting how much you eat just to
keep your blood glucose levels down. This is especially important for children, adolescents
and the elderly. Speak to your dietitian about what is the right amount of food for you.
If you are eating the right amount of food and are still hungry, try to include high fibre, low
fat and low glycemic index foods in your meals and snacks. They can help to keep you
feeling fuller for longer.
Some foods can be eaten without affecting your blood glucose level or body weight. These
are the kind of foods you should aim to eat if you are still hungry. These foods are often
called “free” foods. They include:
• Most vegetables except the starchy vegetables (potato, sweet potato, corn, legumes),
avocado and olives
• Some fruits e.g. lemon, lime, cumquats, loquats, passionfruit, berries and rhubarb.
• Black or green tea* (without milk or sugar)
• Herbal teas
• Coffee* (without milk or sugar)
• Water including soda water and plain mineral water
• Diet soft drinks and cordials
• Clear broth or soup
• Tomato Juice
• Fresh lemon juice without sugar
• Diet jelly
• Herbs and spices
* It is best to limit tea and/or coffee to 4 cups a day.
40
czT kw;Wk; ePhpopT Neha; gw;wpa nghJthd Nfs;tpfs; - njhlUk;
• 1 Nkirf;fuz;b cyHe;j jpuhl;ir my;yJ 4 cyHe;j mg;hpfhl; (apricots)*
• 1 rpwpa thiog;gok; my;yJ ½ nghpa thiog;gok;.
gor;rhW mjpf vhprf;jp (kilojoules) nfhz;lJ. mj;Jld; ehHr;rj;J ,y;yhjJ. gor;rhwhf
mUe;Jtijtpl KOg;gokhf rhg;gpLtJ kpf ey;yJ. mjpfkhf gor;rhW mUe;JtJ ,uj;j
FSNfh]; msTfis caHj;Jk;. mj;Jld; cly; vil $Ltjw;Fk; fhuzkhf ,Uf;Fk;.
ePq;fs; gor;rhW mUe;j Ntz;Lnkd;why;> mjpfgl;rk; xUehisf;F xU rpwpa Nfhg;ig
msTld; epWj;;jpf;nfhs;s Ntz;Lk;.
*cyHe;j goq;fs; ,aw;ifr; rHf;fiuia mjpf mstpy; nfhz;Ls;sd. ePqf
; s; cyHe;j
goq;fs; rhg;gpl Ntz;Lnkd;why; Fiwe;j msTld; epWj;jpf;nfhs;Sq;fs;. vLj;Jf;fhl;lhf>
cyHe;j jpuhl;ir – 1 Nkirf;fuz;b> mj;jpg;gok; - 2 my;yJ nfhl;il ePff
; g;gl;l NghPri
; r – 4.
ehd; fha;fwpfs; fl;Lg;ghL ,y;yhky; rhg;gplyhkh?
ehHr;rj;J> itl;lkpd;fs; kw;Wk; cg;Gr;rj;Jf;fisf; fha;fwpfs; mjpf mstpy;
nfhz;Ls;sd. ghpe;Jiuf;fg;gl;l fha;fwpfspd; msT xU ehisf;F Ie;J my;yJ mjw;F
Nkw;gl;l gq;FfshFk;. xU gq;F fha;fwp vd;gJ ½ Nfhg;ig Ntfitf;fg;gl;l fha;fwpfs;
my;yJ 1 Nfhg;ig rhyl; my;yJ 1 eLj;ju mstpyhd cUisf;fpoq;F* my;yJ ½
Nfhg;ig gaW tiffs; *. mNef fha;fwpfs; ,uj;j FSNfh]; msTfspy; kw;Wk;
cly; vilapy; kpf kpff; Fiwe;j mstpy; ghjpg;G Vw;gLj;Jk; (vLj;Jf;fhl;lhf> rhyl;>
fj;jhpf;fha; kw;Wk; $idg;G+ (artichokes)). ,e;j fha;fwpfs; ‘jhuskhd czTfs;’ vd;W
miof;fg;gLfpd;wd. ,it fl;Lg;ghbd;wp vt;tsT Ntz;LkhdhYk; NrHj;Jf; nfhs;s KbAk;.
*];lhHr; cs;s fha;fwpfs; (mjhtJ cUisf;fpoq;F> rHf;fiuts;spf; fpoq;F> Nrhsk;
kw;Wk; gaWtiffs;) khTr;rj;ijf; nfhz;Ls;sd. mjhtJ ];lhHr;ir FSNfhrhfj;
Jz;lhf;fpagpd; clYf;F rf;jpia toq;Ffpd;wJ. khTr;rj;J nfhz;l fha;fwpfisr;
rj;JzTj; jpl;lj;jpy; ,uj;j FSNfh]; msTfisr; rhpg;gLj;j kpjkhd mstpy;
NrHf;fyhk;.
“gj;jpa” czTfs; cfe;jitah?
gj;jpa czTfs; my;yJ “ePhpopT Neha; cs;NshUf;F cfe;jit” vdf; Fwpf;fg;gl;bUf;Fk;
czTfs; midj;JNk ePhpopT Neha; cs;stHfSf;F gaDs;sit my;y. mit
ngUk;ghYk; cahpa mstpy; vhprf;jp (kilojoules) nfhz;litfshf ,Uf;Fk; my;yJ mjpff;
nfhOg;igf; nfhz;bUf;fyhk;. mj;Jld; mit ngUk;ghYk; mjpf tpiyAilajhfTk;
,Uf;Fk;.
ePq;fs; jtpHf;f Ntz;ba gj;jpa czTfshtd:
• gj;jpa rhf;Nyl;. nghJthf ,itfspy; nfhOg;G mjpfkhf ,Uf;Fk;.
• gj;jpa my;yJ Fiwe;j msT khTr;rj;J gPH. ,t;tif gPHfspy; My;f`hy; mjpfk;
,Uf;Fk;. ,e;j My;f`hy;jhd; khTr;rj;ij tpl mjpf gpur;rpidfis cUthf;ff;$baJ.
ePhpopT Neha; cs;stHfSf;F rpy gj;jpa czTfs; ey;yJjhd;. ,t;tif czTfspy;
NrHe;jpUf;Fk; rHf;fiu nghJthff; $Ljyhf ,Uf;fyhk;. rHf;fiuf;Fg; gjpyhf <f;ty;™
(Equal™), ];g;nyd;lh™ (Splenda™) kw;Wk; ~_fhpd; ™ (Sugarine™) Nghd;w nraw;if
,dpg;Gfisr; NrHj;jhy; mit cq;fs; ,uj;j FSNfh]; msit mjpfkhf caHj;Jk;
vd;W ftiyg;glj; Njitapy;iy. mitfspy; gpd;tUtd mlq;Fk;:
•
•
•
lal; nkd;ghdq;fs;
lal; fhHbay;fs;
lal; n[y;ypfs;.
vdf;F vg;NghJk; grpapUe;jhy; vd;d czTfs; ehd; rhg;gpl KbAk;?
cq;fSf;F mbf;fb grpnaLj;jhy;> cq;fs; ,uj;j FSNfh]; msTfisf;
Fiwg;gjw;nfd;Nw ePq;fs; msTf;F mjpfkhf czitf;
41
What can I add to food to give it more flavour?
It is important to limit salt and foods containing salt. This is because a high salt intake can
cause high blood pressure.
Herbs, spices, chilli, garlic, lemon, lime and vinegar can all be used to add flavour to food
without affecting blood glucose levels or blood pressure. Use your traditional herbs and
spices to maintain the traditional flavour of meals (e.g. mint, black peppercorns, parsley, curry
leaf, fenugreek, mustard seed, turmeric, cumin, ginger, saffron, coriander leaf, coriander seeds,
cloves, anise seeds and cinnamon).
What if I am a vegetarian?
If you follow a vegetarian diet, you may have difficulty obtaining some nutrients, such as iron,
zinc and vitamin B12. Examples of vegetarian foods that naturally contain some or all of these
at risk nutrients include chick peas, lentils, red kidney beans, tofu, nuts, milk, eggs and dark
green leafy vegetables. In addition, some bread and cereal products are now enriched with
these and other nutrients required for good health.
Speak to your dietitian to ensure you are having a balanced diet.
Why should I see a Dietitian?
An Accredited Practising Dietitian is a health professional who can help you manage food
and diabetes. Make an appointment to see a dietitian when you are first diagnosed with
diabetes. You will need a referral from your doctor. When you are first diagnosed, your
dietitian will need to see you a few times. Continue to see a dietitian once or twice a year
from then on.
Your doctor might also suggest you see a dietitian if you are prescribed with medications or
change your medications. This is because medications can affect the balance between food
and your blood glucose levels.
Call Australian Diabetes Council on 1300 342 238 for more information.
If you cannot speak English well, call the free Telephone Interpreter Service (TIS) on 131 450
and ask them to help you to speak to a dietitian from Australian Diabetes Council.
42
fl;Lg;gLj;jpapUf;fpwPHfsh vd;gij cWjpg;gLj;jpf; nfhs;Sq;fs;. ,J Fwpg;ghff;
Foe;ijfs;> ,sk;gUtj;jpdH kw;Wk; KjpNahUf;F mtrpakhFk;. cq;fSf;F rhpahd msT
czT vJntd cq;fs; czTf; fl;Lg;ghL epGzhplk; ciuahLq;fs;.
ePq;fs; rhpahd msT czit vLj;Jf; nfhz;bUe;j NghjpYk;> cq;fSf;F ,d;Dk;
grpapUe;jhy;> mjpf msT ehHr;rj;J> Fiwe;j msT nfhOg;G kw;Wk; Fiwe;j msT
fpisnrkpf; FwpaPL (glycemic index) czTfis cq;fs; rhg;ghL kw;Wk; rpw;Wz;bfspy;
NrHj;Jf;nfhs;Sq;fs;. mit ePq;fs; tapW epiwa rhg;gpl;l czHit ePz;l Neuj;Jf;F
Vw;gLj;j cjTfpwJ.
cq;fs; ,uj;j FSNfh]; msit my;yJ cly; viliag; ghjpf;fhtz;zk; rpy
czTfis cz;z KbAk;. cq;fSf;F mjpf grpapUe;jhy; me;j tifahd czTfis
ePq;fs; cz;zyhk;. ,e;jtif czTfs; nghJthf “jhuhskhd czTfs;” vd;W
miof;fg;gLk;. mtw;wpy; gpd;tUtd mlq;Fk;:
•
khTr;rj;jhd fha;fwpfs; jtpHj;j ngUk;ghyhd fha;fwpfs; (cUisf;fpoq;F>
rHf;fiuts;spf;fpoq;F> Nrhsk;> gaW tiffs;)> mtfhNlh (avocado) kw;Wk; Mypt;
• rpytifg; goq;fs; vLj;Jf;fhl;lhf> vYkpr;ir kw;Wk; mjd; tiffshd nykd;>
iyk;> Fk;f;thl;]; (cumquats), nyhf;thl;]; (loquats), nfhbNjhilg; gok; (passionfruit),
ngHhp kw;Wk; &ghHg; (rhubarb)
• ghy; NrHf;fhj my;yJ gr;irj; Njapiyapy; tbj;j NjePH* (ghy; my;yJ
rHf;fiu ,y;yhky;).
• %ypifj; NjePH
•fhgp* (ghy; my;yJ rHf;fiu ,y;yhky;).
• jz;zPH - Nrhlh kw;Wk; ntWk; kpduy; ePH cl;gl
• gj;jpa nkd;ghdq;fs; kw;Wk; fhHbay;
• njspe;j fQ;rp my;yJ #g;
• jf;fhspr; rhW
• rHf;fiu ,y;yhj Gjpjha;g; gpope;j vYkpr;rk;gor; rhW
• lal; n[y;yp
• %ypif kw;Wk; krhyh.
* NjePH kw;Wk;/my;yJ fhgpia xU ehisf;F 4 Nfhg;ig tiu Fiwj;Jf; nfhs;tJ kpfTk; ey;yJ.
vd;Dila cztpy; Rit $l;Ltjw;F vd;d NrHf;f Ntz;Lk;?
cg;igAk;> cg;G NrHf;fg;gl;l czTfisAk; Fiwj;Jf; nfhs;tJ mtrpakhFk;.
Vndd;why; mjpf msT cg;G vLj;Jf;nfhs;tJ cahpa ,uj;j mOj;jj;ij cz;lhf;Fk;.
%ypiffs;> krhyh nghUl;fs;> kpsfha;> nts;isg;G+z;L> vYkpr;rq;fha;> vYkpr;rk;gok;
kw;Wk; tpdpfH Nghd;witfs; ,uj;j FSNfh]; msTfNsh my;yJ ,uj;j mOj;jNkh
ghjpf;fg;glhky; cztpy; Rit $l;Ltjw;Fg; gad;gLj;j KbAk;. cq;fs; ghuk;ghpa
%ypiffs; kw;Wk; krhyh nghUl;fis cztpy; Ritnflhky; ,Uf;fg; gad;gLj;Jq;fs;.
(vLj;Jf;fhl;lhf> Gjpdh> fUkpsF> Jsrp> fUNtg;gpiy> nte;jak;> fLF> kQ;rs;> rPufk;>
,Q;rp> Fq;Fkk;> nfhj;jky;yp> fpuhk;G> Nrhk;G kw;Wk; ,ytq;fg;gl;il)
ehd; irtkhf ,Ue;jhy; vd;d nra;tJ?
ePq;fs; irt czT rhg;gpLgtuhf ,Ue;jhy;> cq;fSf;F ,Uk;Gr;rj;J (iron)>
Jj;jehfr;rj;J (zinc)> itl;lkpd; gp12 Nghd;w rpy Cl;lr;rj;Jf;fs; fpilf;fr; rpukkhf
,Uf;Fk;. ,aw;ifapNyNa rpw;rpy my;yJ midj;J mgha Cl;lr;rj;Jf;fisf; nfhz;l
irt czTfSf;F vLj;Jf;fhl;L nfhz;ilf; fliy> gUg;G tiffs;> rptg;G fpl;dp gPd;];>
NlhG (tofu)> nfhl;ilfs;> ghy;> Kl;ilfs; kw;Wk; fUk;gr;ir ,iyfSs;s fha;fwpfs;
Nghd;witahFk;. mj;Jld;> ey;y cly;eyj;Jf;Fr; rpy nuhl;b kw;Wk; jhdpag; nghUl;fs;
jw;NghJ ,e;j Cl;lr;rj;Jf;fisAk;> NtW rpy Cl;lr;rj;Jf;fisAk; kpFjpahff;
nfhz;Ls;sd.
ePq;fs; rhptpfpj czit vLj;Jf;nfhs;fpwPHfsh vd;gij cWjpg;gLj;jpf;nfhs;s cq;fs;
czTf; fl;Lg;ghL epGzhplk; ciuahLq;fs;. .
43
44
ehd; Vd; czTf; fl;Lg;ghL epGziuf; fhz Ntz;Lk;?
mq;fPfhpf;fg;gl;l gapw;rp czTf; fl;Lg;ghL epGzH xU Rfhjhuj; njhopy; ty;YeH.
mtH cq;fs; czT kw;Wk; ePhpopT Nehia epHtfpf;f cjtp Ghpa KbAk;. cq;fSf;F
ePhpopT Neha; ,Uf;fpwnjd Kjd;Kjyhff; fz;lwpag;gl;lTld; czTf; fl;Lg;ghL epGzH
xUtiuf; fhz re;jpg;G Vw;ghl;il Vw;gLj;jpf; nfhs;sTk;. cq;fs; kUj;JthplkpUe;J
xU ghpe;Jiuf; fbjk; cq;fSf;Fj; NjitahapUf;Fk;. cq;fSf;F Neha; cs;snjd
Kjd;Kjyhff; fz;lwpag;gl;lTld; czTf; fl;Lg;ghL epGzH rpy jlit cq;fisg;
ghHf;f NehpLk;. mg;NghjpypUe;J tUlj;Jf;F XhpU Kiw njhlHe;J czTf; fl;Lg;ghL
epGziug; ghHf;f Ntz;bajpUf;Fk;.
cq;fSf;F kUe;J tiffisg; ghpe;Jiuf;Fk; NghNjh> my;yJ cq;fs; kUe;J tiffis
khw;Wk;NghNjh> cq;fs; kUj;JtH cq;fs; czTf; fl;Lg;ghL epGzH xUtiug; ghHf;fr;
nry;y MNyhrid toq;fyhk;. Vndd;why; kUe;J tiffs; czT kw;Wk; cq;fs; ,uj;j
FSNfh]; msTfSf;fpilNaahd rkepiyiag; ghjpf;ff;$Lk;.
Nkyjpf tptuq;fSf;F> M];jpNuypa ePhpopT Neha; fTd;rpiy 1300 342 238 vd;w vz;zpy;
miof;fTk;.
cq;fSf;F Mq;fpyj;jpy; ed;whfg; Ngr Kbatpy;iynad;why;> njhiyNgrp
nkhopngaHj;Jiug;Gr; Nritia (TIS) 131 450 vd;w vz;zpy; mioj;J> M];jpNuypa ePhpopT
Neha; fTd;rpypy; ,Ue;J czTf; fl;Lg;ghL epGzH xUthplk; Ngr cq;fSf;F cjtp
Ntz;Lnkdf; NfSq;fs;.
45
9
Diabetes and Alcohol
Too much alcohol is harmful for everyone, including people with diabetes. However, people
with diabetes may still drink some alcohol. If you drink alcohol, drink in moderation and be
aware of the following:
• Alcohol can increase body weight, blood pressure and some blood fats. This can make it
harder to manage your diabetes and increases your risk of heart disease.
• People who use insulin or take some diabetes tablets can have a very low blood glucose
level (hypoglycaemia) after drinking alcohol. Always eat carbohydrate food when drinking
alcohol. Ideally drink alcohol with a meal but if this is not possible snack on carbohydrate
foods like low fat crackers, pretzels or bread.
• The symptoms of drunkenness and hypoglycaemia are similar. People may not offer
you help if they think that you are just drunk. Let the people with you know that you have
diabetes and what to do if you have hypoglycaemia.
Drink alcohol in moderation
Moderate drinking means no more than 2 standard drinks for both women and men per day.
A standard drink is a 285 ml of full strength beer, 375 ml mid-strength beer, 425 ml of light
beer (less than 3% alcohol), 100ml wine, 60 ml sherry or 30ml spirits (incl. whisky and brandy).
It’s a good idea to include alcohol free days each week.
To help reduce how much alcohol you drink
try diluting it by adding water, soda water or
diet soft drink. You could also try alternating
between alcoholic and non-alcoholic drinks.
46
9
ePhpopT NehAk;> kJTk;
mjpf msT kJ mUe;JtJ midtUf;Fk; jPq;F tpistpf;ff;$baJ. ePhpopT Neha;
cs;stHfSk; ,jpy; mlq;Fk;. ,Ug;gpDk;. ePhpopT Neha; cs;stHfs; XusT kJ
mUe;jyhk;. ePq;fs; kJ mUe;Jgtuhf ,Ue;jhy;> kpjkhd mstpy; mUe;Jq;fs;.
mj;Jld; gpd;tUtdtw;wpy; ftdkhapUq;fs;:
•
kJthdJ cly; vil> ,uj;j mOj;jk; kw;Wk; rpy ,uj;jf; nfhOg;G tifis
mjpfhpf;ff;$baJ. ,J cq;fs; ePhpopT Nehia epHtfpg;gijf; fbdkhf;fp> ,ja
Neha;f;fhd mghaj;ij mjpfhpf;fr; nra;fpwJ
• ,d;Rypd; cgNahfpg;gtHfs; my;yJ ePhpopT Neha; khj;jpiufs; rpytw;iw
cl;nfhs;gtHfs; kJ mUe;jpagpd; kpff; Fiwthd ,uj;j FSNfh]; msit
(i`NghfpisrPkpah-hypoglycaemia) ngwyhk;. kJ mUe;jpagpd; vg;NghJk;
khTr;rj;Js;s czit cz;zNtz;Lk;. rhg;ghl;Lld; kJ mUe;JtJjhd; eyk;.
Mdhy; mJ Kbatpy;iynad;why;> Fiwe;j nfhOg;Gs;s tlfk;> khTg; gz;lk;
my;yJ nuhl;b Nghd;w khTr;rj;Js;s rpw;Wz;bfs; vLj;Jf; nfhs;syhk;
• FbNghij kw;Wk; jho; ,uj;jf; FSNfhRf;fhd mwpFwpfs; xNu khjphpahf
,Uf;Fk;. ePq;fs; mg;NghJjhd; Fbj;jpUf;fpwPHfs; vd;W kw;wtHfs; epidj;jhy;
cq;fSf;F cjtpGhpa kWf;fyhk;. cq;fSld; ,Ug;gtHfSf;F ePq;fs;
ePhpopT Nehapdhy; ghjpf;fg;gl;ltH vd;gJk;> cq;fSf;F jho; ,uj;jf; FSf;Nfh];
,Ug;gjhy; vd;d nra;a Ntz;Lk; vd;gJk; njhpal;Lk;.
kJit kpjkhff; FbAq;fs;
kpjkhff; Fbg;gJ vd;gJ xU ehisf;F MZf;Fk; ngz;Zf;Fk; 2 rhjhuz
msTf;F Nkw;glhjjhFk;. rhjhuz msT vd;gJ 285 kp.yp. KOr; rf;jpAs;s gPH
(285 ml of full strength beer)> 375 kp.yp. eLj;jur; rf;jpAs;s gPH (375 ml mid-strength
beer)> 425 kp.yp. rf;jp Fiwe;j gPH (425 ml of light beer) - (3% My;f`hYf;Fk;
FiwT)> 100 kp.yp. xapd; (100 ml wine)> 60 kp.yp. n~Hhp (60 ml sherry)> my;yJ
30 kp.yp. vhprhuhak; (30 ml spirits) - (tp];fp kw;Wk; gpuhe;jp cl;gl). xt;nthU
thuj;jpYk; rpy ehl;fs; kJ mUe;jhky; ,Ug;gJ ey;ynjhU NahridahFk;.
ePq;fs; Fbf;Fk; kJtpd; msitf; Fiwf;f
Ntz;Lkhapd;> jz;zPiuNah> NrhlhitNah
my;yJ lal; nkd;ghdj;ijNah NrHj;J
ePHj;Jg;Nghf itf;f Kaw;rpf;fyhk;. ePq;fs;
kJghdk; kw;Wk; kJ my;yhj ghdk; vd
khwp khwp cgNahfpf;f Kaw;rp nra;ayhk;.
47
10
Physical activity
Daily physical activity is an important part of maintaining a healthy lifestyle. Everybody
receives great benefits from exercise, but for people with diabetes; there are some extra,
more significant benefits as well.
Why it is good for you
Regular physical activity can:
• Lower your blood glucose (sugar) levels and improve your blood glucose
control
• Help make your tablets and/or insulin work better
• Help you to manage your weight or reduce your weight
• Lower blood pressure and blood fats such as cholesterol
• Improve the health and strength of your heart
• Reduce stress and anxiety
• Reduce your risk of developing diabetes complications
• Help you sleep better
• Improve your balance and coordination
• Make you feel great!
What should I be aiming for?
Regular physical activity plays a large part in helping you to manage and
control your diabetes. The amount of activity you should be doing is the
same as everybody else!
Following these four simple guidelines can help put you on the path to good health:
• Think of physical activity as an opportunity, rather than
an inconvenience
• Be active in as many ways as you can.
Create opportunities for activity within your day. For
example, walk to the shops instead of driving, take the
stairs over the lift, or get off the bus one stop early and
walk the extra distance.
It is also important to make these changes within the
workplace. Try walking the longer way to the photocopier,
visiting a colleague rather than emailing, stand up when
talking on the phone or going for a walk during the lunch
break.
• Put together at least 30 minutes of moderate intensity physical activity every day.
Guidelines suggest we aim to do a minimum of 30 minutes every day of physical activity;
but remember these don’t have to be all at once. 30 minutes can be divided into 15 or 10
minute blocks, and they have the same effect. Try exercises that use your whole body in the
movement, such as brisk walking, swimming, dancing or cycling. These activities should be
performed at a level that makes you breathe harder but that you can still talk.
• If possible, do some regular vigorous exercise for extra health and fitness.
Vigorous means that you are now exercising at a level that makes you huff and puff. Only do
this type of activity if you have your doctor’s okay and are managing your current exercises well.
48
10
cly;hPjpahd nray;ghLfs;
xU MNuhf;fpakhd tho;f;ifKiwf;F md;whl cly; nray;ghLfs; kpfTk; mtrpakhFk;.
vy;NyhUk; clw;gapw;rp %yk; kpfg;ngUk; ed;ikfisg; ngWfpd;wdH. Mdhy; ePhpopT
NehAs;stHfSf;F ,d;Dk; mjpfkhd Fwpg;gplj;jf;f tifapy; ed;ikfs; cs;sd.
vjdhy; mJ vdf;F ey;yJ?
xOq;fhd cly; nray;ghLfs; gpd;tUtdtw;iwr; rhj;jpakhf;Fk;:
• cq;fs; ,uj;j FSNfh]; (rHf;fiu) msTfisf; Fiwf;Fk;. kw;Wk;
cq;fs; ,uj;j FSNfh]; fl;Lg;ghl;il Nkk;gLj;Jk;
• cq;fs; khj;jpiufs; kw;Wk;/my;yJ ,d;Rypd; ed;F Ntiy nra;a
cjt GhpAk;
• cq;fs; vilia epHtfpf;fNth my;yJ Fiwf;fNth cjtp nra;Ak;
• ,uj;j mOj;;jj;ijAk;> nfhy];buhy; Nghd;w ,uj;jf; nfhOg;igAk;
Fiwf;Fk;
• cq;fs; ,jaj;jpd; MNuhf;fpak; kw;Wk; typikia Nkk;gLj;Jk;
• kd mOj;jj;ijAk;> kdf; ftiyiaAk; Fiwf;Fk;
• ePhpopT Neha;g; gpur;rpidfspdhy; cUthFk; mghaj;ijf; Fiwf;Fk;
• ePq;fs; ed;whf cwq;Ftjw;F cjtpGhpAk;
• cq;fs; kdj;jpd; rkdepiyiaAk;> xUq;fpizg;igAk; Nkk;gLj;Jk;
• cq;fSf;Fs; ey;y Gj;JzHit cUthf;Fk;!
ehd; ve;j Fwpf;Nfhis Nehf;fpr; nry;y Ntz;Lk;?
xOq;fhd cly; nray;ghLfs;> cq;fs; ePhpopT Nehia epHtfpg;gjpy;
kw;Wk; fl;Lg;gLj;Jtjpy; ngUk; gq;F tfpf;fpd;wd. kw;wtHfs; ve;j msT
nra;fpwhHfNsh mNj msT nray;ghLfs; ePq;fSk; nra;a Ntz;Lk;!
gpd;tUk; ehd;F vspa topfhl;ly;fs; ePq;fs; ey;y
MNuhf;fpag; ghijf;Fr; nry;y cjtpGhpAk;:
• cly; nray;ghLfisr; rpukk; vd;W vz;zhky; xU
ey;y tha;g;G vd;W epidAq;fs;.
• cq;fshy; Kbe;j msT vy;yh tifapYk;
RWRWg;ghf ,Uq;fs;.
cq;fSf;Ff; fpilf;Fk; Neuj;Jf;Fs; nray;gl Ntz;ba
tha;g;ig Vw;gLj;jpf; nfhs;Sq;fs;. vLj;Jf;fhl;lhf>
filfSf;F tz;bapy; nry;yhky; ele;J nry;Yq;fs;.
ypg;by; nry;yhky; gbf;fl;il cgNahfpAq;fs;.
NgUe;jpypUe;J xU epWj;jj;jpw;F Kd;Ng ,wq;fp>
,ilg;gl;l J}uj;Jf;F ele;J nry;Yq;fs;.
,e;jtif khw;wq;fis NtiyghHf;Fk; ,lj;Jf;Fs;Sk; nra;tJ mtrpakhFk;. efy;
vLf;Fk; ,ae;jpuj;Jf;F ele;Nj nry;y Kaw;rp nra;Aq;fs;. cld; Ntiy ghHg;gtUf;F
kpd;dQ;ry; nra;tij tpl NehpNy nrd;W ghUq;fs;. njhiyNgrpapy; NgRk;NghJ
epd;Wnfhz;bUq;fs; my;yJ kjpa czT ,ilNtisapd;NghJ eilg;gapw;rp nra;Aq;fs;.
• xt;nthU ehSk; Fiwe;j gl;rk; 30 epkplq;fSf;F kpjkhd cly; nray;ghLfis
nkhj;jkhf ,izj;Jr; nra;Aq;fs;
49
Physical activity - continued
What about Resistance Training?
You should also aim to include some kind of weight or resistance training during the week.
Resistance training means any exercise or activity where you use your body to lift something
or to work against a weight, force or gravity. Resistance training is great for helping you to
keep active and independent for longer and has additional benefits for people with diabetes.
Resistance training can:
• Improve the way your body uses and stores insulin
• Increases your muscle mass. This increases how much energy you burn which helps with
weight loss/ management and improving blood glucose control
• Decrease your risk of falling and the risk of fractures
• Improve strength, power, balance and coordination.
How much resistance training
do I need to be doing for good
health?
• Try to lift weights (e.g. cans of
food, hand weights) two - three
times a week
• Include exercises that target
all of your large muscle groups
including your arms and legs
• Aim to do each exercise eight twelve times (repetitions), and perform two - three lots (sets) of each exercise
• Start at a light weight till you learn the correct technique. After you have mastered this
weight, try lifting a heavier weight
• Ideally, aim to lift a weight that only allows you to do eight - twelve repetitions each time.
Precautions to take before initiating an exercise program:
If you plan to start an exercise program for the first time, or you are doing something new,
visit your doctor for medical clearance before you begin.
It is also important to understand how your medications work together with physical
activity. Exercise works like insulin and lowers your blood glucose levels (sugar). In people
who are taking insulin or some oral medications the combined effect with exercise can
cause hypoglycemia. To avoid this, it is important to regularly test your blood glucose levels
(sugars) before, sometimes during, immediately after and again a couple of hours after
exercise, so you understand how your body responds to different activities. If you find that
your blood glucose is falling too low, you may need to alter your diabetes medication or eat
extra carbohydrates to account for this effect. However, consult with your doctor, diabetes
educator or dietitian before making these changes.
There are also some times when you should avoid exercise; if your blood glucose levels
(sugars) are above 15 mmol/L, if you are feeling unwell or lightheaded (dizzy) or if you are
unsure how to perform an exercise correctly.
Most important!
Enjoy the activities you chose. Be active in as many ways as you can, every day and remember
you don’t have to take it seriously, just regularly.
Always speak with your doctor before beginning a new physical activity program. If you
require more guidance or advice about exercising with diabetes, speak with an accredited
exercise physiologist.
50
cly;hPjpahd nray;ghLfs; - njhlUk;
ehk; xt;nthU ehSk; Fiwe;jgl;rk;; 30 epkplq;fs; cly; nray;ghLfis Nkw;nfhs;s
topfhl;ly;fs; mwpTWj;Jfpd;wd. Mdhy; ,ij xNuabahf ,ilntspapy;yhky; nra;a
Ntz;bajpy;iy vd;gij epidtpy; itj;Jf; nfhs;Sq;fs;. 30 epkplq;fs; 15 my;yJ 10
epkplj; njhFjpfshfg; gphpj;Jf; nfhz;lhYk; mNj tpisTfs;jhd; Vw;gLk;. KO cliyAk;
gad;gLj;Jk; tpjkhf Ntfkhf elj;jy;> ePr;ry;> eldk; my;yJ irf;fps; Xl;Ljy; Nghd;w
clw;gapw;rpfis Kaw;rpf;fTk;. ,e;j nray;ghLfs; ePq;fs; %r;rpiwg;G Vw;gl;L> MapDk;
NgrKbAk; vd;fpw msTf;Fr; nra;ag;gl Ntz;Lk;.
• cq;fshy; KbAkhdhy;> Nkyhd MNuhf;fpaj;Jf;Fk;> cly;jFjpf;Fk; fLikahd rpy
clw;gapw;rpfis xOq;fhfr; nra;aTk;.
ePq;fs; ,g;NghJ nra;J nfhz;bUf;Fk; clw;gapw;rpapd; epiy cq;fis Nky;%r;R fPo;%r;R
thq;fr; nra;jhy; mJ fLikahdjhFk;. cq;fs; kUj;JtH rhpnad;W nrhd;dhy;> mj;Jld;
cq;fs; jw;Nghija clw;gapw;rpis ey;y Kiwapy; ePq;fs; epHtfpj;Jf; nfhz;bUe;jhy;
kl;LNk ,t;tpjkhd nray;ghLfisr; nra;Aq;fs;.
jilg;gapw;rp vd;why; vd;d?
ePq;fs; rpy tifahd vilg;gapw;rp
my;yJ jilg;gapw;rpia
thuk; KOtJk; NrHg;gijAk;
Nehf;fkhff; nfhs;s Ntz;Lk;.
jilg;gapw;rp vd;gJ cq;fs;
cliyg; gad;gLj;jp vijahtJ
J}f;FtJ my;yJ vil> rf;jp
my;yJ GtpaPHg;ig vjpHj;J Ntiy
nra;tJ Nghd;w clw;gapw;rp my;yJ nray;ghLfshFk;. ePq;fs; RWRWg;ghf ,Uf;fTk;>
mjpf fhyk; kw;wtiur; rhHe;jpuhky; ,Uf;fTk; jilg;gapw;rp kpfTk; cjtpGhpfpwJ. ePhpopT
Neha; cs;stHfSf;F ,J NkYk; gy ed;ikfisj; jUfpwJ.
jilg;gapw;rp gpd;tUtdtw;iwr; rhj;jpakhf;Fk
• cq;fs; cly; ,d;Rypidg; gad;gLj;JtijAk;> Nrkpj;J itg;gijAk; Nkk;gLj;JfpwJ
• cq;fs; jir vilia mjpfhpf;fpwJ. ,J ePq;fs; nrytopf;f Ntz;ba rf;jpiaf;
•
•
$l;b cq;fs; viliaf; Fiwf;f/epHtfpf;f cjTfpwJ. ,jd;%yk; ,uj;j FSNfh];
fl;Lg;ghl;ilAk; Nkk;gLj;JfpwJ.
ePq;fs; fPNo tpOe;J tplf;$ba mghaj;ijAk;> vYk;G KwpAk; mghaj;ijAk; Fiwf;fpwJ
gyk;> rf;jp> rkepiy kw;Wk; xUq;fpizg;G ,itfis Nkk;gLj;JfpwJ.
ey;y MNuhf;fpa epiyapy; ,Uf;f vt;tsT jilg;gapw;rp vdf;Fj; Njitg;gLk;?
• thuj;Jf;F ,uz;L Kjy; %d;W Kiw vilfis (vLj;Jf;fhl;lhf> czT lg;ghf;fs;>
ifapdhy; J}f;Fk; vilfs;) J}f;f Kaw;rp nra;Aq;fs;
• cq;fs; iffs; kw;Wk; fhy;fs; cl;gl ngUk; jirj; njhFjpfis ,yf;F itj;J
nra;ag;gLk; cly;gapw;rpfisr; NrUq;fs;
• xt;nthU clw;gapw;rpiaAk; vl;L Kjy; gd;dpuz;L jlit (jpUk;gj; jpUk;g) nra;aTk;>
xt;nthU clw;gapw;rpiaAk; ,uz;L Kjy; %d;W gFjpfshf (njhFg;Gfs;) nra;aTk;
,yf;F itj;Jf; nfhs;Sq;fs;
• rhpahd EZf;fj;ijf; fw;Fk;tiu Kjypy; ,Nyrhd vilapy; Muk;gpAq;fs;. ,e;j
vilapy; ePq;fs; ed;F gofpagpd;> fdkhd viliaj; J}f;f Kaw;rpAq;fs;.
• cq;fshy; xt;nthU KiwAk; vl;L Kjy; gd;dpuz;L jlit J}f;f Kbfpd;w vilia
,yf;F itj;Jf; nfhs;Sq;fs;.
xU clw;gapw;rpr; nray;jpl;lj;ijj; njhlq;FKd; ftdpf;f Ntz;ba Kd;ndr;rhpf;iffs;:
ePq;fs; Kjd;Kiwahf xU clw;gapw;rpr; nray;jpl;lj;ijj; njhlq;fj; jpl;lkpl;lhNyh>
my;yJ Gjpjhf vijahtJ nra;jhNyh> mijj; njhlq;FKd; kUj;Jt ,iritg; ngw
cq;fs; kUj;Jthplk; nry;Yq;fs;.
51
52
cly;hPjpahd nray;ghLfs; - njhlUk;
cq;fs; kUe;Jfs; cly;hPjpahd nray;ghLfSld; vt;thW xj;Jg;NghfpwJ vd;gij
mwpe;Jnfhs;tJk; mtrpakhFk;. clw;gapw;rp ,d;Rypidg; Nghd;W Ntiy nra;fpwJ. mJ
cq;fs; ,uj;j FSNfh]; (rHf;fiu) msTfisf; Fiwf;fpwJ. ,d;Rypd; my;yJ rpy
tha;top kUe;Jfs; vLj;Jf;nfhs;gtHfs; clw;gapw;rp nra;tjhy; ,t;tpuz;Lk; ,ize;j
tpisTfs; i`NghfpisrPkpahit (hypoglycemia) cz;lhf;fyhk;. ,ijj; jtpHg;gjw;F
ePq;fs; cq;fs; ,uj;j FSNfh]; msTfis (rHf;fiu) clw;gapw;rp nra;tjw;F
Kd;Gk;> rpy rkaq;fspy; nra;Jnfhz;bUf;Fk;NghJk;> mjd;gpd; nra;J Kbj;jTlDk;>
,Wjpahf clw;gapw;rp nra;j ,uz;L kzpNeuk; fopj;Jk; xOq;fhf Nrhjid nra;J
nfhs;tJ mtrpakhFk;. ,jdhy; cq;fs; cly; ntt;NtW nray;ghLfSf;F vt;thW
vjpHtpid GhpfpwJ vd;gij ePq;fs; mwpe;J nfhs;syhk;. cq;fs; ,uj;j FSNfh];
kpfTk; fPopwq;Ftijf; fz;lwpe;jhy;> ePq;fs; cq;fs; ePhpopT Neha; kUe;J tiffis
khw;w Ntz;bajpUf;Fk; my;yJ mijr; rhpnra;a ,d;Dk; mjpf khTr;rj;J czTfis
cz;z Ntz;bajpUf;Fk;. ,Ue;jNghjpYk;> ,e;j khw;wq;fisr; nra;tjw;FKd; cq;fs;
kUj;JtH> ePhpopT Neha;f; fy;tpahsH my;yJ czTf; fl;Lg;ghL epGzH ,tHfisf; fye;J
MNyhrpj;Jf; nfhs;Sq;fs;.
ePq;fs; clw;gapw;rpiaj; jtpHf;f Ntz;ba rpy Neuq;fSk; cz;L: cq;fs; ,uj;j
FSNfh]; msTfs; (rHf;fiu) 15 mmol/L –msTf;F Nky; NghdhNyh> ePq;fs;
cly;eykpy;yhky; NghdhNyh> my;yJ jiyr;Rw;wy; (kaf;fk;) Vw;gl;lhNyh my;yJ
clw;gapw;rpia rhpahf vt;thW nra;tJ vd;gJ cq;fSf;F epr;rakhfj; njhpahky;
NghdhNyh fl;lhak; jtpHf;f Ntz;Lk;.
kpfTk; Kf;fpak;!
ePq;fs; NjHe;njLj;jpUf;Fk; nray;ghLfis mDgtpAq;fs;. xt;nthU ehSk; cq;fshy;
Kbe;jtiu vy;yhtifapYk; RWRWg;ghf ,Uq;fs;. ePq;fs; ,ij xOq;fhfr; nra;Aq;fs;>
mNjrkaj;jpy; jPtpukhf vLj;Jf;nfhs;sj; Njitapy;iy vd;gijAk; epidtpy; itj;Jf;
nfhs;Sq;fs;.
vg;NghJk; xU Gjpa cly;hPjpahd nray;ghl;Lj; jpl;lj;ijj; njhlq;FKd; cq;fs;
kUj;Jthplk; ciuahLq;fs;. ePhpopT Nehia itj;Jf; nfhz;L clw;gapw;rp nra;tijg;
gw;wp ,d;Dk; mjpf topfhl;LjNyh my;yJ MNyhridNah cq;fSf;Fj; Njitg;gl;lhy;>
mq;fPfhuk; ngw;w clw;gapw;rp clypayhshplk; ciuahLq;fs;.
53
11
Oral Medications
Type 2 diabetes is a progressive disease. Even though you can be doing all the right things
to manage your diabetes, it may be necessary to start medication to keep healthy blood
glucose (sugar) levels.
When starting new medication you need to ask your doctor and pharmacist:
• How many tablets you should take
• How often you should take your tablets
• What time of the day you should take your tablets whether before food, with food or after food
• How your tablets work
• The side effects
• How your tablets affect or are affected by other
medications you are taking.
Over time your medications may not work as well.
For this reason it is recommended to have your
medications reviewed by your doctor every year.
Your local pharmacist can also help you understand
your medications.
Do not stop, decrease or increase your medication without first discussing it with your doctor
or diabetes educator.
Do not share your medications with anyone else.
Certain diabetes medication can increase the risk of a low blood glucose level
(hypoglycaemia). It is essential to know how to recognise and treat low blood glucose or
hypoglycaemia. Ask your doctor, pharmacist or diabetes educator if this applies to you.
If you are having frequent episodes of hypoglycaemia it is very important to speak with your
family doctor or diabetes health care team.
Further assistance with your medications:
Home Medication Review:
If you are taking five or more different medicines, talk to your doctor about arranging
a home medication review by your local pharmacist.
National Prescribing Service:
For information over the phone regarding the expert use of any of your medications
you can contact the National Prescribing Service consumer enquiry line “Medicines
Line” on 1300 633 424.
54
11
tha;top kUe;Jfs;
ePhpopT Neha; tif 2 xU tsUk; Neha;. cq;fs; ePhpopT Nehia epHtfpf;f vy;yhtpjkhd
rhpahd nray;fisAk; nra;Jnfhz;L ,Ue;jhYk;> MNuhf;fpakhd ,uj;j FSNfh];
(rHf;fiu) msTfisg; guhkhpf;f kUe;J tiffisj; njhlq;FtJ mtrpakhf ,Uf;fyhk;.
GJ kUe;J tiffisj; njhlq;Fk;NghJ ePq;fs; cq;fs; kUj;JtiuAk;> kUe;jhSeiuAk;
gpd;tUtdtw;iwf; Nfl;Lf;nfhs;s Ntz;Lk;:
• vj;jid khj;jpiufs; ePq;fs; vLf;f Ntz;Lk;
• vj;jid jlit cq;fs; khj;jpiufis ePq;fs;
vLf;f Ntz;Lk;
• cq;fs; khj;jpiufis ehspd; ve;j Ntisapy;
vLf;f Ntz;Lk; - rhg;ghl;Lf;F Kd;dhyh>
rhg;ghl;Lldh my;yJ rhg;ghl;Lf;Fg; gpd;dhyh
• cq;fs; khj;jpiufs; vg;gb Ntiy nra;fpd;wd
•gf;ftpisTfs;
• vt;thW cq;fs; khj;jpiufs; kw;w kUe;J
tiffisg; ghjp;f;fpd;wd my;yJ kw;w
kUe;Jtiffs; cq;fs; khj;jpiuiag; ghjpf;fpd;wd.
fhyg;Nghf;fpy; cq;fs; kUe;J tiffs; ed;whf
Ntiynra;ahky; Nghfyhk;. Mifahy; cq;fs; kUe;J
tiffs; xt;nthU tUlKk; cq;fs; kUj;Jtuhy; kW
Ma;T nra;ag;gl Ntz;Lnkdg; ghpe;Jiuf;fg;gLfpd;wd.
cq;fs; kUe;J tiffisg; Ghpe;Jnfhs;tjw;F cs;@H kUe;jhSeUk; cq;fSf;F
cjtpGhpaf;$Lk;.
Kjypy; cq;fs; kUj;JthplNkh my;yJ ePhpopT Neha;f; fy;tpahshplNkh
fye;jhNyhrpf;fhky; cq;fs; kUe;J tifia epWj;jNth> Fiwf;fNth> $l;lNth Ntz;lhk;.
NtW ahhplKk; cq;fs; kUe;J tiffis gq;fpl;Lf; nfhs;s Ntz;lhk;.
rpy ePhpopT Neha; kUe;J tiffs; jho; ,uj;j FSNfh]; msit (hypoglycaemia)
Vw;gLj;Jk; mghaj;ij mjpfhpf;ff;$Lk;. Fiwe;j ,uj;j FSNfh]; my;yJ
i`NghfpisrPkpahit vg;gb milahsk; fz;Lnfhs;tJ kw;Wk; rpfpr;ir mspg;gJ vd;gij
mwpe;Jnfhs;tJ mtrpakhFk;. ,J cq;fSf;Fg; nghUe;Jnkd;why; cq;fs; kUj;JtH>
kUe;jhSeH my;yJ ePhpopT Neha;f; fy;tpahsH ,tHfsplk; NfSq;fs;.
,uj;j FSNfh]; msT mbf;fb FiwAk; epfo;Tfs; cq;fSf;F Vw;gl;lhy;> cq;fs; FLk;g
kUj;JthplNkh my;yJ ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FOtplNkh NgRtJ kpfTk;
Kf;fpakhFk;.
cq;fs; kUe;J tiffs; gw;wpa Nkyjpf cjtpf;F:
tPl;L kUe;Jfs; kWMa;T:
ePq;fs; Ie;J my;yJ mjw;F Nkw;gl;l tifahd kUe;Jfs; vLj;Jf; nfhz;L
,Ue;jhy;> cq;fs; cs;@H kUe;jhSeuhy; tPl;L kUe;J kWMa;T nra;tjw;F
Vw;ghL nra;a cq;fs; kUj;Jthplk; NgRq;fs;.
Njrpa
ghpe;Jiur; Nrit:
cq;fs; kUe;J tiffis vg;gbj; NjHe;j Kiwapy; gad;gLj;JtJ vd;gJ gw;wpj;
njhiyNgrpapy; Nkyjpf tptuq;fs; Njitg;gl;lhy;> Njrpa ghpe;Jiur; Nrit
tprhuizj; njhlHghd “kUe;J ,izg;ig” (Medicines Line) 1300 633 424
vd;w vz;zpy; miof;fyhk;.
55
12
Insulin
The pancreas is a part of the body situated behind the stomach that produces a hormone
called insulin.
Without insulin, the cells in our bodies would not be able to use the glucose (sugar) to provide
energy.
In type 1 diabetes the pancreas does not make any insulin and
glucose levels build up in the blood. Insulin by injection or by
insulin pump is required for life. A person with type 2 diabetes or
gestational diabetes may also require insulin to keep their blood
glucose levels within the recommended range.
Your doctor may decide that insulin is needed as well as oral
medications, or that insulin may be better than oral medications.
This does not mean that you have failed in your diabetes
management. It has been decided that insulin is necessary to
maintain good diabetes management.
All insulins lower blood glucose levels. Low blood glucose or
hypoglycaemia can be a side effect of insulin treatment. It is
essential to know how to recognise and treat low blood glucose or
a hypoglycaemic episode.
There are many types of insulins available, you and your doctor
will discuss which is right for you. If you have any questions or
concerns about starting on insulin you can also contact your
diabetes educator.
Key points to know are:
• Type and amount of insulin to be used
• Time to take your insulin and when to eat
• The time your insulin has it’s greatest effect and how long it stays in your body
• When to test your blood glucose (sugar) level
• When to contact your doctor or diabetes health care team.
Tell your doctor or diabetes educator of any changes in your lifestyle, working
hours, physical activity or meal times. They will advise you if you need to change
your insulin treatment .
56
12
,d;Rypd;
tapw;Wf;Fg; gpd;Gwj;jpy; mike;jpUf;Fk; fizak; vd;w ghfk; ,d;Rypd; vd;w
`hHNkhidr; Ruf;fpwJ.
,d;Rypd; ,y;yhky;> ekJ clypy; cs;s nry;fs; rf;jpia toq;Fk; FSNfhir
(rHf;fiu) gad;gLj;j KbahJ.
ePhpopT Neha; tif 1-,;y; fizak; ve;j ,d;RypidAk;
jahhpf;f KbahJ. mjd;gpd; FSNfh]; msTfs;
,uj;jj;jpy; Nru Muk;gpf;Fk;. capHjhpf;f ,d;Rypd;
Crp %ykhfNth> ,d;Rypd; Foha; %ykhfNth
Njitg;gLfpwJ. ePhpopT Neha; tif 2 cs;stHfSf;Nfh
my;yJ fHg;g ePhpopT cs;stHfSf;Nfh ,uj;j FSNfh];
msTfisg; ghpe;Jiuf;fg;gl;l tiuaiwf;Fs; itj;jpUf;f
,d;Rypd; Njitg;glyhk;.
,d;RypNdhL tha;top kUe;J tiffSk; Njitg;gLk;
my;yJ tha;top kUe;ijtpl ,d;Rypd; rpwe;jJ
vd;gij cq;fs; kUj;JtH KbntLg;ghH. ePqf
; s;
cq;fs; ePhpopT Neha; epHthfj;jpy; Njhy;tp mile;J
tpl;BHfs; vd;gJ mjw;Fg; nghUsy;y. ey;y ePhpopT
Neha; epHthfj;ijg; guhkhpf;f ,d;Rypd; mtrpak; vd;gJ
KbntLf;fg;gl;Ls;sJ.
vy;yh ,d;Rypd;fSk; ,uj;j FSNfh]; msTfisf;
Fiwf;fpd;wd. Fiwe;j ,uj;j FSNfh]; my;y
; J
i`NghfpisrPkpah ,d;Rypd; rpfpr;irapd;
gf;ftpisthFk;. Fiwe;j ,uj;j FSNfh]; msT
my;yJ jho; ,uj;jf; FSNfhir vg;gb milahsk; fz;Lnfhs;tJ kw;Wk; rpfpr;ir
mspg;gJ vd;gij mwpe;Jnfhs;tJ mtrpakhFk;.
gytifahd ,d;Rypd;fs; fpilf;fpd;wd. ePqf
; Sk;> cq;fs; kUj;JtUk;
fye;jhNyhrpj;J vJ cq;fSf;F rhpahdJ vd KbT nra;Aq;fs;. ,d;Rypidj;
njhlq;FtJ gw;wp cq;fSf;F VjhtJ Nfs;tpfNsh my;yJ ftiyfNsh ,Ue;jhy;
ePqf
; s; cq;fs; ePhpopT Neha;f; fy;tpahshplk; njhlHG nfhz;L Nfl;Lf; nfhs;syhk;.
mwpe;J nfhs;sNtz;ba Kf;fpakhd fUj;Jf;fshtd:
• vd;d tifahd kw;Wk; vd;d mstpyhd ,d;Rypd; gad;gLj;jg;gl Ntz;Lk;
• cq;fs; ,d;Rypid vLj;Jf;nfhs;s Ntz;ba Neuk; kw;Wk; czT
cl;nfhs;StJ vg;NghJ
• cq;fs; ,d;Rypd; mjpfgl;r tPhpak; ,Uf;Fk; Neuk; kw;Wk; cq;fs; clypy;
vt;tsT Neuk; ,Uf;Fk;
•cq;fs; ,uj;j FSNfh]; (rHf;fiu) msit vg;NghJ ghpNrhjid
nra;a Ntz;Lk;.
• vg;NghJ cq;fs; kUj;Jtiu my;yJ Rfhjhug; guhkhpg;Gf; FOitj; njhlHG
nfhs;s Ntz;Lk;.
cq;fs; tho;f;ifKiwapy;> Ntiy Neuj;jpy;> cly; nray;ghLfspy; my;yJ
rhg;gpLlk; Neuq;fspy; ve;jtpj khw;wk; ,Ue;jhYk;> cq;fs; kUj;JtH my;yJ ePhpopT
Neha;f; fy;tpahshplk; njhptpf;fTk;. cq;fs; ,d;Rypd; rpfpr;irapy; VJk; khw;wk;
Njitah vd;gij mtHfs; cq;fsplk; mwpTiu mspg;ghHfs;.
57
Sharps disposal
What are “community sharps”?
Community sharps are medical devices that penetrate the skin and
are used in the home.
They include:
• Needles – used to give injections, draw blood or insert insulin
pump tubing
• Syringes (even if needle removed)
• Pen needles for insulin pens
• Blood glucose or finger pricker lancets.
Your used sharps must be secured in a strong puncture resistant
container, Australian Standard Sharps containers (available from the
Australian Diabetes Council and some pharmacies) or a puncture
resistant plastic container with a screw top lid are suitable.
Sharps must NOT be placed in any rubbish or recycling bins.
How do I dispose of my community sharps?
Place sharps in an appropriate container. Dispose of containers only into community sharps
disposal facilities found at:
• Public hospitals
• Participating pharmacies
• Community sharps disposal bins
• Needle and syringe program outlets.
For a list of sharps disposal facilities in your area contact your local council or phone the
Australian Diabetes Council on 1300 342 238.
58
Crpfis mg;Gwg;gLj;Jjy;
“r%f Crpfs;” vd;why; vd;d?
R%f Crpfs; vd;gJ Njhiy CLUtpj; Jisaplg;
gad;gLj;jg;gLk; kUj;Jt cgfuzk;. ,it tPlb
; y;
gad;gLj;jg;gLtjhFk;.
mtw;wpy; gpd;tUgit mlq;Fk;:
• Crpfs; - CrpNghl> ,uj;jj;ij CwpQ;r my;yJ
,d;Rypd; Foha; ,izg;Gf;Fg; gad;gLgit
• kUe;J}rpfs; (Crp ePff
; g;gl;l gpwFk;)
• ,d;Rypd; Ngdhf;fSf;F Ngdh Crpfs;
• ,uj;j FSNfh]; my;yJ tpuy;
Edpiaj; JisapLk; $Hfj;jpfs;
ePqf
; s; cgNahfpj;J Kbj;j Crpfisg; gykhd>
Xl;ilaplKbahj xU nfhs;fyDf;Fs; ghJfhg;ghfg; Nghl
Ntz;Lk;. M];jpNuypaj; juepiy Crpfs; nfhs;fyd;fs; (M];jpNuypa ePhpopT Neha;
fTd;rpypYk;> kUe;Jf;filfs; rpytw;wpYk; fpilf;Fk;) my;yJ jpUF%bAld; $ba
Xl;ilaplKbahj gpsh];bf; nfhs;fyd; nghUj;jkhdit.
Crpfisf; Fg;igapNyh my;yJ kWRow;rpf; $ilapNyh Nghlf; $lhJ.
vd;Dila r%f Crpfis vg;gb ehd; mg;Gwg;gLj;JtJ?
Crpfisj; jFe;j nfhs;fyd;fspy; NghlTk;. nfhs;fyd;fisr; r%f Crpfs;
mg;Gwg;gLj;Jk; trjpAs;s gpd;tUk; ,lq;fspy;jhd; mg;Gwg;gLj;j Ntz;Lk;:
• nghJ kUj;Jtkidfs;
• gq;FngWk; kUe;Jf;filfs;
• r%f Crpfs; mg;Gwg;gLj;Jk; njhl;bfs;
• Crp kw;Wk; kUe;J}rp ntspNaw;w epfo;rr
; pj;jpl;lk;.
cq;fs; gFjpapYs;s Crpfs; mg;Gwg;gLj;Jk; trjpAs;s ,lq;fspd; gl;baYf;F
cq;fs; cs;@H fTd;rpiyj; njhlHG nfhs;Sq;fs; my;yJ M];jpNuypa ePhpopT
Neha;f; fTd;rpiy 1300 342 238 vd;w vz;Zf;Fj; njhiyNgrpapy; mioAq;fs;.
59
13
Blood Glucose (Sugar) Monitoring
Monitoring blood glucose levels is important to help you manage
your diabetes. Self blood glucose testing is a way of measuring how
much glucose is in your blood.
A drop of blood is obtained by pricking the finger with a needle
called a lancet. The blood is applied to a test strip, and inserted into
a blood glucose machine (meter). The blood glucose(sugar) level is
then displayed.
There are many types of meters available. Ask your doctor or diabetes educator which meter
suits you. You will also need to be shown how to use your meter.
Why you should monitor your blood glucose (sugar) level
Blood glucose levels respond to food, particularly carbohydrates. Other factors like physical
activity, diabetes medication, changes in your daily routine, stress and illness will also cause
blood glucose levels to go up or down.
Visits to a doctor or heath professional may be weeks or months apart. It is important to
know and understand the readings/blood glucose levels and make some self-management
decisions in between doctors visits.
The benefits of using a meter include:
• Seeing if your blood glucose level is too high or too low
• Gives you a picture of your day to day diabetes management
• Shows you whether your blood glucose levels are within your
recommended target range
• Shows you the effects of food, physical activity and medication on
your blood glucose (sugar) level
• Gives you confidence to self-manage your diabetes.
This gives you and your diabetes health care team the information needed to help you
manage your diabetes.
When you should monitor your blood glucose (sugar) level
Blood glucose monitoring is usually done before meals or two hours after the start of a main
meal. Ask your doctor or diabetes educator for advice on when and how often you need to
check your blood glucose level.
It is safe practice to check your blood glucose level before driving and on long journeys,
especially for those people who are at risk of hypoglycaemia.
Monitor your blood glucose level more often:
• If you are sick
• When adjusting tablets or insulin doses
• When blood glucose levels are high -for example over 15 mmol/L
• After exercise
• After alcohol intake.
60
13
,uj;j FSNfh]; (rHf;fiu) msitf;
fz;fhzpj;jy;
cq;fs; ePhpopT Nehia epHtfpg;gjpy; cjtp nra;a ,uj;j FSNfh];
msTfisf; fz;fhzpg;gJ mtrpakhFk;. ,uj;j FSNfh]; Ra
ghpNrhjid vd;gJ cq;fs; ,uj;jj;jpy; vt;tsT FSNfh]; cs;sJ
vd;gij msg;gjw;fhd xU topahFk;.
$Hfj;jp (lancet) vd;W miof;fg;gLk; xU Crpahy; tpuypy; Fj;jp xU
Jsp ,uj;jk; vLf;fg;gLk;. me;j ,uj;jk; xU Nrhjidg; gl;ilapy;
jltg;gl;L> ,uj;j FSNfh]; ,ae;jpuj;jpy; (kPll
; H) nrUfg;gLk;. mjd;gpd; ,uj;j FSNfh];
(rHf;fiu) msT mjpy; njhpAk;.
gy tifahd kPll
; Hfs; fpilf;Fk;. ve;j tifahd kPll
; H cq;fSf;Fg; nghUe;Jnkd
cq;fs; kUj;JtH my;yJ ePhpopT Neha; fy;tpahshplk; NfSq;fs;. cq;fs; kPll
; iu vg;gbg;
gad;gLj;JtJ vd;gijg; gw;wpa tptuKk; cq;fSf;Ff; fhz;gpf;fg;gl Ntz;Lk;.
cq;fs; ,uj;j FSNfh]; (rHf;fiu) msit ePqf
; s; fz;fhzpf;f Ntz;ba mtrpak; Vd;?
,uj;j FSNfh]; msTfs; czTf;F> mjpYk; Fwpg;ghf khTr;rj;Jf;fSf;F Vw;g khWgLk;.
cly; nray;ghLfs;> ePhpopT Neha; kUe;J tiffs;> cq;fs; md;whl tho;fi
; f Kiwapy;
khw;wq;fs;> kd mOj;jk; kw;Wk; RftPdk; Nghd;w kw;w fhuzpfSk; ,uj;j FSNfh];
msTfis caHj;jNth> Fiwf;fNth nra;Ak;.
kUj;JthplNkh my;yJ Rfhjhu njhopy; ty;YdhplNkh nry;YtJ
gy thuq;fs; my;yJ khjq;fs; ,ilntspapy; ,Uf;fyhk;.
kUj;JtHfsplk; nry;tjw;F ,ilg;gl;l fhyq;fspy;> ,uj;j FSNfh];
msTfisg; gw;wp mwpe;J nfhs;tJk;> Ghpe;J nfhs;tJk;> Ra epHthf
KbTfis vLg;gJk; mtrpakhFk;.
•
•
•
•
•
kPl
P l
; H xd;iwg; gad;gLj;Jtjhy; Vw;gLk; ed;ikfspy; gpd;tUgit
mlq;Fk;:
cq;fs; ,uj;j FSNfh]; msT kpf caHe;jpUf;fpwjh my;yJ kpfj; jho;ej
; pUf;fpwjh
vd;gijg; ghHf;fyhk;
cq;fs; md;whl ePhpopT Neha; epHthfj;ijg; gw;wpa xU tbtj;ij cq;fSf;Fj; jUfpwJ.
cq;fSila ,uj;j FSNfh]; msTfs; cq;fSf;Fg; ghpe;Jiuf;fg;gl;l ,yf;F
tiuaiwf;Fs; ,Uf;fpwjhntdf; fhz;gpf;fpwJ
czT> cly; nray;ghLfs; kw;Wk; kUe;J tiffs;> cq;fs; ,uj;j FSNfh]; (rHf;fiu)
msitg; ghjpg;gijf; fhz;gpf;fpwJ
cq;fs; ePhpopT Nehia ePqf
; s; Rakhf epHtfpf;f cq;fSf;F ek;gpf;ifiaj; jUfpwJ.
,J cq;fSf;Fk;> cq;fs; ePhpopT Rfhjhug; guhkhpg;Gf; FOTf;Fk; cq;fs; ePhpopT Nehia
epHtfpf;f cjTk; tifapy; Njitahd jfty;fisj; jUfpwJ.
ePqf
; s; vg;NghJ cq;fs; ,uj;j FSNfh]; (rHf;fiu) msitf; fz;fhzpf;f Ntz;Lk;
,uj;j FSNfh]; fz;fhzpg;G vd;gJ nghJthfr; rhg;ghl;Lf;F Kd;dhNyh my;yJ Kf;fpa
rhg;ghl;ilj; njhlq;Ftjw;F ,uz;L kzp Neuj;Jf;Fg; gpd;dhNyh Muk;gpf;fg;gl Ntz;Lk;.
cq;fs; ,uj;j FSNfh]; msit vj;jid Kiw ePqf
; s; Nrhjid nra;a Ntz;Lk; vd;gijg;
gw;wpa MNyhridf;F cq;fs; kUj;Jtiuf; NfSq;fs;.
thfdj;ij Xl;Lk; Kd;Ngh my;yJ ePzl
; J}ug; gazj;jpd; NghNjh cq;fs; ,uj;j FSNfh];
msitr; Nrhjid nra;J nfhs;tJ ghJfhg;ghd nray;KiwahFk;. ,J Fwpg;ghf jho;
,uj;jf; FSNfh]; (hypoglycaemia) mghak; cs;stHfSf;Fg; nghUe;Jk;.
61
What my blood glucose levels should be?
For most people with type 2 diabetes the recommended range for blood glucose levels is 6 to
8 mmol/L fasting/before meals and 6 to 10 mmol/L two hours after the start of a main meal.
Your doctor will advise you on what blood glucose level will be best for you.
The Glycated Haemoglobin (HbA1c) Blood Test
Blood glucose monitoring with a meter gives you a picture of your day to day diabetes
management. There is another important blood test called glycosylated haemoglobin –
more commonly known as HbA1c. This blood test gives you a picture of your blood glucose
control over the last two to three months and is arranged by your doctor.
The generally recommended HbA1c target level in people with type 2 diabetes is 7% or less.
Your HbA1c should be checked at least every 6 months.
If your HbA1c is greater than 7% it should be checked every three months.You will need
to speak to your diabetes health care team about your diabetes management goals and
possible changes to your diabetes management and treatment.
62
cq;fs; ,uj;j FSNfh]; msitg; gpd;tUk; Neuq;fspy; mbf;fb fz;fhzpAq;fs;:
• ePq;fs; RftPdKw;wpUf;Fk;NghJ
• khj;jpiufisNah> ,d;Rypd; msTfisNah khw;Wk;NghJ
• ,uj;j FSNfh]; msTfs; mjpfkha; ,Uf;Fk;NghJ – vLj;Jf;fhl;lhf 15 mmol/L
–f;Fk; Nky; ,Uf;Fk;NghJ
• clw;gapw;rpf;Fg; gpd;
• kJ mUe;jpa gpd;.
vd;Dila ,uj;j FSNfh]; msTfs; vt;tsT ,Uf;f Ntz;Lk;
ePhpopT Neha; tif 2 cs;s ngUk;ghyhdtHfSf;F> ,uj;j FSNfh]; msTfspd;
ghpe;Jiuf;fg;gl;l tiuaiwahdJ rhg;ghL ,y;yhky;/rhg;ghl;Lf;F Kd; 6 to 8 mmol/L.
mjd;gpd;> Kf;fpar; rhg;ghl;ilj; njhlq;fp ,uz;L kzp Neuj;Jf;Fg; gpwF 6 to 10 mmol/L.
ve;j ,uj;j FSNfh]; msT cq;fSf;F kpfr; rpwe;jJ vd;gij cq;fs; kUj;JtH
MNyhrid toq;FthH.
fpisNfll; `PNkhFNshgpd; (Glycated Haemoglobin (HbA1c)) ,uj;jg; ghpNrhjid
kPl;lH xd;Wld; $ba ,uj;j FSNfh]; fz;fhzpg;G cq;fSila md;whl
ePhpopT Neha; epHthfj;ijg; gw;wpa xU tbtj;ij cq;fSf;Fj; jUfpwJ.
fpisNfhrpNyll; `PNkhFNshgpd; (glycosylated haemoglobin) vd;W miof;fg;gLk;
kw;nwhU Kf;fpakhd ,uj;jg; ghpNrhjid cz;L. ,J nghJthf HbA1c vd;W
mwpag;gLk; NrhjidahFk;. ,e;j ,uj;jg; ghpNrhjid> fle;j ,uz;bypUe;J
%d;W khjq;fSf;Fhpa cq;fs; ,uj;j FSNfh]; fl;Lg;ghl;ilg; gw;wpa xU
tbtj;ij cq;fSf;Fj; jUfpwJ. ,e;jg; ghpNrhjid cq;fs; kUj;Jtuhy; Vw;ghL
nra;ag;gLfpwJ.
ePhpopT Neha; tif 2 nfhz;Ls;s kf;fSf;F nghJthf ghpe;Jiuf;fg;gl;l HbA1c
,yf;F 7% my;yJ mjw;Ff; FiwthdjhFk;.
cq;fs; HbA1c Fiwe;jgl;rk; 6 khjj;Jf;nfhU KiwahtJ fl;lhak; ghpNrhjid
nra;ag;gl Ntz;Lk;.
cq;fs; HbA1c 7%-f;F Nky; nrd;Wtpl;lhy;> mJ %d;W khjj;Jf;nfhU Kiw
ghpNrhjid nra;ag;gl Ntz;Lk;. cq;fs; ePhpopT Neha;; epHthf ,yf;Ffs;
kw;Wk; cq;fs; ePhpopT epHthfk; kw;Wk; rpfpr;irapy; Vw;gLk; khw;wq;fs; gw;wpa
rhj;jpaf;$Wfis mwpe;Jnfhs;s ePq;fs; cq;fs; ePhpopT Rfhjhu guhkhpg;Gf;
FOtplk; ciuahl Ntz;Lk;.
63
14
Short Term Complications –
Hypoglycaemia
Hypoglycaemia (low blood glucose levels)
Hypoglycaemia is when the blood glucose (sugar) level drops below 4 mmol/L. It can
happen very quickly.
Hypoglycaemia can occur in people who take certain oral diabetes
medication or use insulin.
Ask your doctor or health care team if this applies to you.
It is essential to know how to recognise the signs and symptoms of
having low blood glucose (sugar) and how to treat it.
Blood glucose levels can be low because of:
• Delayed or missed meals
• Not enough carbohydrate in the meal
• Extra activity or more strenuous activity
• Too much diabetes medication
• Alcohol.
Signs and Symptoms
These can vary from person to person and may include:
• Dizziness/light headedness
• Sweating
• Headache
• Weakness, shaking
• Tingling around the lips and fingers
• Hunger
• Mood changes, irritable/tearful
• Confusion/lack of concentration
If you feel any of these signs and symptoms, test your blood glucose level if possible.
Treatment for low blood glucose levels (hypos) in a person who is conscious,
cooperative and able to swallow.
If you are unable to test, treat anyway.
Treatment for low blood glucose levels (Hypos)
Step 1
Take quickly absorbed carbohydrate such as:
• Half a glass of juice OR
• 6 to 7 jellybeans OR
• Half a can of regular (not diet) soft drink OR
• 3 teaspoons of sugar OR honey
Retest the blood glucose level after 10 - 15 minutes.
If still below 4 mmol/L repeat Step 1
64
14
FWfpa fhy rpf;fy;fs; - ,uj;jj;j
; py;
rHf;fiuf; FiwT (Hypoglycaemia)
,uj;jj;jpy; rHf;fiuf; FiwT (Hypoglycaemia) (Fiwe;j ,uj;j FSNfh]; msTfs;)
(low blood glucose levels)
i`NghfpisrPkpah vd;gJ ,uj;j FSNfh]; msT 4 mmol/L vd;gjw;Fk; fPNo ,wq;fp
tpLtJjhd;. mJ cldbaha; ele;J tpLk;.
rpy tha;top ePhpopT Neha; kUe;J tiffs; vLg;gtHfSf;Nfh
my;yJ ,d;Rypd; gad;gLj;JgtHfSf;Nfh i`NghfpisrPkpah
tuf;$Lk;.
(,J cq;fSf;Fg; nghUe;jp te;jhy;> cq;fs; kUj;JthplNkh
my;yJ Rfhjhug; guhkhpg;Gf; FOtplk; NfSq;fs;)
Fiwe;j msT ,uj;j FSNfhRf;fhd (rHf;fiu) milahsq;fisAk;> mwpFwpfisAk;
vg;gbf; fz;Lnfhs;tJ vd;gJk;> vg;gb mijf; Fzkhf;FtJ vd;gJk; mtrpakhFk;.
,uj;j FSNfh]; msTfs; FiwthapUg;gjw;Ff; fhuzk;:
• fhyk; jho;j;jg;gl;l my;yJ tpl;Lg;Nghd czTfs;
• cztpy; Njitahd msT khTg;nghUs; ,y;yhik
• mjpfg;gbahd nray;ghLfs; my;yJ mjpff; fLikahd nray;ghLfs;
• kpf mjpfkhd ,d;Rypd; my;yJ ePhpopT Neha; kUe;J tiffs;
• kJ.
milahsq;fSk;> mwpFwpfSk;
,it xUtUf;nfhUtH khWglf;$Lk;. ,itfspy; gpd;tUgit mlq;ff;$Lk;:
• kaf;fk;/jiy Nyrhtijg; Nghy czHT
• tpaHj;jy;
• jiytyp
• cly; gytPdk;> eLf;fk;
• cjLfs; kw;Wk; tpuy;fisr; Rw;wpf; $r;r czHT
• grp
• kNdhght khw;wq;fs;> vhpr;ry;/fz;zPH ngUFjy;
• Fog;gk;/ftdr;rpjwy;.
,e;j milahsq;fs;> mwpFwpfs; vitahtJ cq;fSf;F ,Ug;gjhfj; njhpe;jhy;>
cq;fs; ,uj;j FSNfh]; msit> Kbe;jhy;> Nrhjid nra;aTk
cq;fshy; Nrhjid Nkw;nfhs;s Kbahtpl;lhy;> rpfpr;irahtJ vLj;Jf;nfhs;Sq;fs;.
Fiwe;j ,uj;j FSNfh]; msTfSf;fhd (Hypos) rpfpr;ir
Kjy; epiy
vspjpy; cl;fpufpf;ff;$ba gpd;tUk; khTr;rj;Jf;fis cldbahf vLj;Jf; nfhs;sTk;:
• miuf; Nfhg;ig gor;rhW my;yJ
• 6–7 n[y;yp gPd;]; my;yJ
• miuf; Ftis rhjhuz (lal; my;y) nkd;ghdk; my;yJ
• 3 Njf;fuz;b rHf;fiu my;yJ Njd;
10-15 epkplq;fSf;Fg; gpwF ,uj;j FSNfh]; msit kWKiw Nrhjid nra;aTk;.
mjw;Fg; gpwFk; msT 4 mmol/L -f;Ff; Fiwthf ,Ue;jhy; Kjy; epiyiaj;
jpUk;gTk; nra;aTk;.
65
Short Term Complications – Hypoglycaemia - continued
Step 2
If your next meal is more than 20 minutes away, follow up with more slowly absorbed
carbohydrate such as:
• 2 plain biscuits e.g. 2 Arrowroot or 2 milk coffee biscuits OR
• 1 slice of bread OR
• 1 glass of milk or soy milk OR
• 1 piece of fruit
• 1 tub of low fat yoghurt.
If not treated the blood glucose levels can continue to drop, resulting in:
• Loss of coordination
• Confusion
• Slurred speech
• Loss of consciousness/fitting.
THIS IS AN EMERGENCY ! !
Instructions for the person present during this emergency:
If the person having a hypo is unconscious they
must not be given anything by mouth.
• Place the person in the ‘recovery position’ or on
their side
• Make sure the airway is clear
• Ring 000 or if using a mobile ring 112 for an
ambulance stating “ diabetic emergency”
• An unconscious person must NOT be left alone
• If you are able and trained, give a Glucagon injection
Important points for the person at risk of hypoglycaemia
• Always carry ‘hypo’ food with you if you are on insulin or at risk of
hypoglycaemia. Ask your doctor if this applies to you.
• Carry identification to say you have diabetes
• Test before driving, before and after exercising and after alcohol intake
66
FWfpa fhy rpf;fy;fs; - ,uj;jj;jpy; rHf;fiuf; FiwT - njhlUk;
,uz;lhk; epiy
mLj;jNtisr; rhg;ghl;L Neuk; 20 epkplq;fSf;F Nky; ,Ue;jhy;> gpd;tUtd Nghd;w>
kpfTk; nkJthf cl;fpufpf;ff;$ba gpd;tUk; khTr;rj;Jf;fis vLj;Jf; nfhs;sTk;:
• 2 ntWk; gp];fl;Lfs;> vLj;Jf;fhl;lhf - 2 MNuh&l; gp];fl;Lfs; my;yJ 2 ghy; fhgp
gp];fl;Lfs; my;yJ
• 1 nuhl;bj; Jz;L my;yJ
• 1 Nfhg;;ig ghy; my;yJ Nrhah ghy; my;yJ
• 1 goj; Jz;L
• 1 fpz;zk; Fiwe;j msT nfhOg;Gs;s NahfHl;.
rpfpr;ir mspf;fhky; Nghdhy;> ,uj;j FSNfh]; msTfs; njhlHe;J Fiwe;J nfhz;Nl
Ngha;> gpd;tUk; tpisTfSf;F Mshf;fp tpLk;:
• kd xUq;fpizg;ig ,oj;jy;
• Fog;gk;
• Ngr;Rf; Fowy;
• Raepidit ,oj;jy; / eyk; ,oj;jy;.
,J kpfTk; mtruepiyahFk;!!
,t;tpj mtru epiyapy; cs;stHfSf;fhd
mwpTiufs;:
Fiwe;j ,uj;jr; rHf;fiu msT epiyikf;Fr;
nrd;W> epidtpoe;j egUf;F tha;topahf
vJTk; juNt $lhJ.
• me;j egiu ‘nefpo;T epiyapy;’ (recovery
position) my;yJ gf;fthl;by; gLf;fitf;f
Ntz;Lk;
• %r;Rf;Foha; jilapy;yhky; ,Uf;FkhW nra;J nfhs;sTk;
•Mk;Gyd;Rf;fhf 000 vd;w vz;Zf;Nfh my;yJ ifj;njhiyNgrp
gad;gLj;Jtjhf ,Ue;jhy;> 112 vd;w vz;Zf;Nfh mioj;J> “ePhpopT
Neha; mtru cjtp” vd;W Fwpg;gpLq;fs;
• epidtpoe;j egiuj; jdpahf tpl;Lr;nry;yf; $lhJ
• ePq;fs; gapw;rpaspf;fg;gl;L> cq;fshy; KbAnkd;why; FSffhd;
(Glucagon) Crpiag; NghlTk;.
,uj;jj;jpy; rHf;fiuf; FiwT mghak; cs;stHfSf;fhd Kf;fpaf;
fUj;Jfs;
• ePqf
; s; ,d;Rypd; vLj;Jf; nfhz;bUe;jhNyh>
,uj;jj;jpy; rHf;fiuf; FiwT mghaj;jpy;
,Ue;jhNyh> ‘rHf;fiuf; Fiwthd’
czTfis vg;NghJk; vLj;Jr; nry;Yq;fs;.
,J cq;fSf;Fg; nghUe;Jnkd;why;>
cq;fs; kUj;Jtiuf; NfSq;fs;
• cq;fSf;F ePhpopT Neha;
,Uf;fpwnjd;gijj; njhptpf;fpd;w
milahsr; rhd;iw vLj;Jr; nry;Yq;fs;
• thfdk; Xl;Ltjw;F Kd;Gk;> clw;gapw;rp
nra;tjw;F Kd;Dk;> gpd;Dk;> kJ
mUe;Jtjw;Fg; gpd;Gk; ghpNrhjid nra;J
nfhs;Sq;fs;.
67
15
Short term complications – high blood
glucose (sugar) level (hyperglycaemia,
DKA, HONK/HHS, and sick days)
Hyperglycaemia or high blood glucose levels is when the blood glucose (sugar) levels are
much higher than recommended – above 15mmol/L.
Blood glucose levels go high because of:
• Eating too much carbohydrate
• Not taking enough insulin or oral diabetes medications
• Sickness or infection
• Emotional, physical or mental stress
• Certain tablets or medicines, (including cortisone or steroids)
• A problem with your blood glucose meter, strips or testing technique
• Lumps present at the injection site (if on insulin)
• Fingers not clean when testing your blood
• Testing too soon after eating. (Check your blood glucose two hours after the start of a
main meal).
Signs and Symptoms
You may feel:
• Tired
• Thirsty
• Pass urine more frequently
• Blurred vision
• Generally unwell.
If feeling unwell
• Test your blood glucose levels more often: at least every 2 – 4 hours
• Drink fluids and continue to eat normally if possible
• Treat the cause of the illness
• Tell someone and have them check on you.
Test for ketones if advised to do so by your doctor.
When do I need to call my doctor?
Contact your doctor for advice during illness if:
• You can’t eat normally
• You are not well enough to monitor your blood glucose levels
• Your blood glucose level is higher than 15 mmol/L for more than 12 hours
• Vomiting or diarrhoea continues for more than 12 hours
• You continue to feel unwell or become drowsy.
It is important to have a written sick day management plan prepared before you get
sick or unwell. Talk to your diabetes health care team to arrange this.
Ketone Testing and Diabetic Ketoacidosis (DKA)
Ketones are chemicals in the blood which are produced from the breakdown of fat. If the
body has no insulin present, glucose (sugar) can’t be used for energy. Therefore the body
makes ketones to provide a different source of energy. This may occur due to poor control of
diabetes, not enough insulin or missed insulin doses, illness or infection.
68
15
Fiwe;jfhy gpur;rpidfs; - caH
,uj;j FSNfh]; (rHf;fiu) msT
(,uj;jj;jpy; $Ljy; rHf;fiu vdg;gLk;
i`Nghfpisrpkpah> DKA, HONK/HHS
kw;Wk; Neha;tha;g;gl;l ehl;fs;)
i`Nghfpisrpkpah my;yJ caH ,uj;j FSNfh]; msTfs; vd;gJ ,uj;j FSNfh];
(rHf;fiu) msTfs; ghpe;Jiuf;fg;gl;lij tpl kpf mjpfkhf ,Uf;Fk; - 15 mmol/L -f;F Nky;.
,uj;j FSNfh]; msTfs; caHtjw;fhd fhuzq;fs;:
• mjpfkhf khTr;rj;J cl;nfhs;Sjy;
• ,d;Rypd; my;yJ tha;top ePhpopT Neha; kUe;J tiffisj; Njitahd msT
vLj;Jf; nfhs;shky; ,Uj;jy;
• Neha;tha;g;gLjy; my;yJ Neha;j; njhw;W
• czHThPjpahd> cly;hPjpahd my;yJ kdhPjpahd mOj;jk;
• rpy khj;jpiufs; my;yJ kUe;J tiffs; (fhHbNrhd; (cortisone) my;yJ
];Buha;l;fs; (steroids))
• cq;fs; ,uj;j FSNfh]; kPl;lH> gl;ilfs; my;yJ Nrhjid njhopy;El;gj;jpy;
xU gpur;rpid
• (,d;Rypd; kUe;J) Crp Nghlg;gl;Ls;s ,lj;jpy; fhzg;gLk; tPf;fk;
• cq;fs; ,uj;jj;ijr; Nrhjid nra;Ak;NghJ tpuy;fs; Rj;jkpy;yhky; ,Uj;jy;
• rhg;gpl;l kpfr; rpwpJ Neuj;jpNyNa Nrhjid nra;jy; (Kf;fpa rhg;ghl;ilj;
njhlq;Ftjw;F ,uz;L kzp Neuj;Jf;Fg; gpwF cq;fs; ,uj;j FSNfhirr;
Nrhjid nra;a Ntz;Lk;).
milahsq;fSk;> mwpFwpfSk;
cq;fSf;F gpd;tUk; czHTfs; Vw;glyhk;:
•NrhHT
•jhfk;
• mbf;fb rpWePH fopj;jy;
• kq;fyhd ghHit
• nghJthd RftPdk;.
RftPdkhapUe;jhy;
cq;fs; ,uj;j FSNfh]; msTfis mbf;fb Nrhjid nra;aTk;: Fiwe;jgl;rk; 2-4
kzp Neuj;Jf;F xU jlit
• jput czTfis mUe;jp> Kbe;jtiu> rhjhuzkhfr; rhg;gpLk; czTfisNa
cz;Zq;fs;
• Nehapd; fhuzj;ij mwpe;J rpfpr;ir mspf;fTk;
• ahhplkhtJ nrhy;yp> cq;fis ghpNrhjid nra;ar; nrhy;yTk.
•
cq;fs; kUj;Jtuhy; MNyhrid nfhLf;fg;gl;lhy; fpNlhd;]; (ketones) Nrhjid nra;J nfhs;Sq;fs;.
vg;NghJ ehd; vd; kUj;Jtiuf; $g;gpl Ntz;bajpUf;Fk;?
Neha;tha;g;gl;l Neuj;jpy; gpd;tUk; #o;epiy Vw;gl;lhy;. MNyhrid ngw cq;fs;
kUj;Jtiuj; njhlHG nfhs;Sq;fs:;
• cq;fs; ,uj;j FSNfh]; msTfisf; fz;fhzpf;fNth> rhg;gplNth my;yJ Fbf;fNth
cq;fshy; Kbatpy;iynad;why;
• cq;fs; ,uj;j FSNfh]; msT 12 kzp Neuj;Jf;F Nky; 15 mmol/L msittpl
mjpfkhf ,Ue;jhy;
• 12 kzp Neuj;Jf;F Nky; the;jp my;yJ tapw;Wg; Nghf;F njhlHe;J ePbj;jhy;
• njhlHe;J ePq;fs; RftPdKw;wpUe;jhy; my;yJ miu kaf;f epiyapy; ,Ue;jhy; .
69
A build up of ketones can lead to a condition called ketoacidosis, requiring urgent medical
attention. Diabetic ketoacidosis (DKA) is a life threatening condition that usually only occurs
in people with type 1 diabetes. It causes dehydration and a buildup of acids in the blood.
This results in vomiting and increased drowsiness.
DKA IS AN EMERGENCY AND REQUIRES URGENT MEDICAL ATTENTION
In very rare cases ketoacidosis can occur in people with type 2 diabetes and is
usually caused by a serious infection.
With type 2 diabetes it is not usually necessary to test for ketones. Discuss with your diabetes
health care team if you need to check for ketones.
There are two methods of testing for ketones – testing urine and
testing blood :
Urine Ketone Test
Urine test strips are available to check for ketones. Ask your
pharmacist about the types of urine ketone strips available and
carefully follow the directions for testing. Urine ketone tests must be
timed exactly using a watch or clock with a secondhand.
Blood Ketone Test meter
There are meters available to test blood for ketones. The same drop
of blood to be tested for glucose can be used to test for ketones. Different test strips are
used for testing glucose and ketones. Ketone test strips are not subsidised by the National
Diabetes Services Scheme at present.
Seek URGENT medical attention if:
• The urine ketone test shows medium or high levels of urine ketones.
• The blood ketone test result is higher than 0.6 mmol/L.
Hyperosmolar Hyperglycaemic Syndrome (HHS) - previously known as Hyper
Osmolar Non Ketotic coma (HONK)
HHS is a complication of type 2 diabetes that involves extremely high blood glucose (sugar)
levels without the presence of ketones. This medical emergency occurs in anyone with type
2 diabetes, regardless of treatment.
When blood glucose levels are very high, the body tries to get rid of the excess glucose
(sugar) in the urine. This significantly increases the amount of urine and often leads to
dehydration so severe that it can cause seizures, coma and even death.
The main causes of HHS/ HONK are:
• Undiagnosed type 2 diabetes
• A current illness or infection e.g. pneumonia and urinary tract infection
• Other major illnesses e.g. stroke, heart attack
• Persistent physical or emotional stress
• Certain medication. This is another reason you need to talk to your diabetes health care
team about the medications you are taking.
Signs and Symptoms include:
• Severe dehydration
• Shock
• Changes in consciousness
• Coma.
HHS/HONK requires URGENT medical attention.
70
ePq;fs; Neha;tha;g;gLjw;F my;yJ cly;eykpy;yhky; Nghtjw;F Kd;> Neha;tha;g;gl;l
ehSf;fhd Nkyhz;ikj; jpl;lj;ij vOjp itj;Jf; nfhs;tJ mtrpakhFk;. ,ij Vw;ghL
nra;tjw;F cq;fs; ePhpopT Neha; Rfhjhuf; FOtplk; ciuahLq;fs;.
fPNlhd; (Ketone) ghpNrhjid kw;Wk; ePhpopT Neha; fPNlhmrpNlhrp]; (Diabetic
Ketoacidosis (DKA))
fPNlhd;fs; vd;gJ ,uj;jj;jpy; cs;s ,urhadg; nghUl;fshFk;. mit cilf;fg;gl;l
nfhOg;Gg; nghUspypUe;J jahhpf;fg;gLfpd;wd. clypy; ,d;Rypd; ,y;iynad;why;>
FSNfhir (rHf;fiu) rf;jpahf khw;w cjt KbahJ. MfNt cly; xU tpj;jpahrkhd
rf;jpia toq;f fPNlhd;fis cUthf;FfpwJ. ,jw;F Nkhrkhd fl;Lg;ghl;by; cs;s ePhpopT
Neha;> ,d;Rypd; gw;whf;Fiw my;yJ tpl;Lg;Nghd ,d;Rypd; kUe;J my;yJ Neha;j; njhw;W
fhuzkhf ,Uf;fyhk;.
fPNlhd;fs; ngUfpf; nfhz;Nl Nghdhy; mJ ,Wjpapy;
fPNlhmrpNlhrp]; (ketoacidosis) vd;w epiyikf;Ff; nfhz;L
nrd;W> cldb kUj;Jt cjtp Njitg;gLk; epiyikf;F
Mshf;fp tpLk;. ePhpopT Neha; fPNlhmrpNlhrp]; (DKA) vd;gJ
capUf;F Mgj;jhd epiyahFk;. ,J ePhpopT Neha; tif 1 –
My; ghjpf;fg;gl;Ls;stHfSf;F kl;Lk;jhd; nghJthf Vw;gLk;.
,J ePH tw;wpLk; epiyia cUthf;fp> ,uj;jj;jpy; mkpyq;fisg;
ngUf;fptpLk;. ,jd; tpisthf the;jp kw;Wk; mjpfkhd miukaf;f
epiyAk; cUthFk;.
DKA vd;gJ xU mtrufhyj; Njit. mjw;F cldb kUj;Jt cjtp Njitg;gLk;
fPNlhmrpNlhrp]; kpf kpf mhpjhd Neuq;fspy;> ePhpopT Neha; tif 2 –My;
ghjpf;fg;gl;Ls;stHfSf;F Vw;gLk;. mj;Jld; nghJthf mJ xU Neha;j; njhw;why; Vw;gLk;.
ePhpopT tif 2-f;F> fPNlhd;fSf;fhfg; nghJthfg; ghpNrhjid nra;aj; Njitapy;iy.
fPNlhd;fisr; rhpghHf;fj; Njit ,Ue;jhy;> cq;fs; ePhpopT Neha; Rfhjhug; guhkhpg;Gg;
FOtplk; fye;jhNyhrpj;Jf; nfhs;sTk;.
fPNlhd;fSf;fhf ghpNrhjid nra;tjpy; ,uz;L Kiwfs; cz;L – rpWePHg; ghpNrhjid
kw;Wk; ,uj;jg; ghpNrhjid:
rpWePH fPNlhd; ghpNrhjid
fPNlhd;fisr; Nrhjid nra;tjw;Fr; rpWePH Nrhjidg; gl;ilfs; fpilf;Fk;. ve;j tifahd
rpWePH fPNlhd; gl;ilfs; fpilf;fpwnjd cq;fs; kUe;jhSehplk; NfSq;fs;. mj;Jld;
Nrhjid nra;tjw;fhd topKiwfisg; gpd;gw;Wq;fs;. rpWePH fPNlhd; Nrhjidfis tpdhb
Ks; cs;s xU iff;fbfhuk; my;yJ fbfhuj;ijg; gad;gLj;jpj; Jy;ypjkhf Neuj;ijf;
fzf;fpl Ntz;Lk;.
,uj;j fPNlhd; ghpNrhjid kPl;lH
fPNlhd;fSf;fhf ,uj;j Nrhjid nra;tjw;F kPl;lHfs; fpilf;Fk;. FSNfhirr; Nrhjid
nra;ag; gad;gl;l mNj ,uj;jj;Jspia fPNlhd;fisr; Nrhjid nra;aTk; gad;gLj;j
KbAk;. FSNfhirAk;> fPNlhd;fisAk; Nrhjid nra;tjw;Fj; jdpj;jdpahd Nrhjidg;
gl;ilfs; gad;gLj;j Ntz;Lk;. fPNlhd; Nrhjidg; gl;ilfs; jw;NghJ Njrpa ePhpopT
Neha;r; Nritfs; jpl;lj;jpd; (National Diabetes Services Scheme) mbg;gilapy; khdpak;
toq;fg;gLgit my;y.
gpd;tUgit VJk; Nehpl;lhy; cldb kUj;Jt cjtpia ehlTk;:
• rpWePH fPNlhd; Nrhjidapy;> rpWePHf; fPNlhd;fs; eLj;ju my;yJ caHe;j
msTfisf; fz;gpj;;jhy;
• ,uj;j fPNlhd; Nrhjidapd; KbT 0.6 mmol/L msit tpl mjpfkhf ,Ue;jhy;
71
72
Hyper Osmolar Non Ketotic coma (HONK) vd;W Kd;G miof;fg;gl;l Hyperosmolar
Hyperglycaemic Syndrome (HHS)
HHS vd;gJ ePhpopT Neha; tif 2-,d; rpf;fyhd Neha;f;Fwpak;. ,jpy; fPNlhd;fs;
,y;yhky; kpf caHe;j ,uj;j FSNfh]; (rHf;fiu) msTfs; cs;sd. ,e;j
kUj;Jt mtruepiy ePhpopT Neha; tif 2 –My; ghjpf;fg;gl;NlhH vtUf;Fk;
ve;jtpj rpfpr;ir nfhLf;fg;gl;l NghjpYk;> tuf;$Lk;.
,uj;j FSNfh]; msTfs; kpfTk; caUk;NghJ> cly; mjpfkhAs;s FSNfhir
(rHf;fiu) rpWePH topahf ntspNaw;WfpwJ. ,J rpWePhpd; msit fzprkhf
mjpfhpj;Jg; ngUk;;ghYk; ePH tw;wpLk; epiyf;Ff; nfhz;L nrd;wpLk;. me;epiy kpfTk;
fLikahfp typg;G> Nfhkh mj;Jld; ,wg;Gf;Nf toptFj;J tpLk;.
HHS/ HONK epiyf;fhd Kf;fpa fhuzq;fs;:
rhpahff; fz;lwpahky; tpl;l ePhpopT Neha; tif 2
jw;Nghija Neha; my;yJ Neha;j; njhw;W. vLj;Jf;fhl;lhf> EiuaPuy; mow;rp
(epNkhdpah) kw;Wk; rpWePHf; Foha; Neha;j;njhw;W
• kw;w nghpa Neha;fs; vLj;Jf;fhl;lhf gf;fthjk;> khuilg;G
• ,iltplhj cly;hPjpahd my;yJ czHr;rphPjpahd mOj;jk;
• rpy kUe;J tiffs;. ePq;fs; vLj;Jf;nfhz;L ,Uf;Fk; kUe;J tiffisg; gw;wp cq;fs; ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FOtplk; Ngr Ntz;bapUg;gjw;F
,JTk; kw;WnkhU fhuzkhFk;.
•
•
milahsq;fs; kw;Wk; mwpFwpfspy; gpd;tUgit mlq;Fk;:
• fLikahd ePH tw;wpLk; epiy
•mjpHr;rp
• Raepidtpy; khw;wq;fs;
•Nfhkh.
HHS/HONK –f;F cldbahd kUj;Jt cjtp Njit.
73
16
Chronic complications
Blood glucose (sugar) levels that remain high for long periods of time can cause diabetes
related complications such as eye disease, kidney disease, nerve damage as well as heart
disease and circulation problems. High blood glucose levels also increase the risk of infection
and slow down recovery from infection. For these reasons it is very important that you try
and keep your blood glucose levels within the ranges recommended by your doctor or
diabetes health care team.
Diabetes and eye disease:
Damage can occur to the back of the eye (retina) where there are very fine blood vessels
important for vision. This is called diabetic retinopathy. The development of retinopathy is
strongly related to how long you have had diabetes and how well the blood glucose levels
have been controlled.
High blood pressure, high cholesterol levels and kidney failure can also affect the severity of
diabetic retinopathy.
Vision loss or blindness is preventable through early detection and treatment.
The treatment for diabetic retinopathy can be laser therapy or surgery.
Glaucoma and cataracts can occur at an earlier age and more often in people with diabetes.
Cataracts affect the eye’s lens causing it to become cloudy with a loss of vision. The treatment
for cataracts is surgery.
Glaucoma occurs when the pressure inside the eye becomes very high, causing damage to
the optic nerve. The treatment for glaucoma can be eye drops, laser therapy or surgery.
Diabetes and kidney disease:
Your kidneys help to clean your blood. They remove waste from the blood and pass it out of
the body as urine.
Over time diabetes can cause damage to the kidneys. If the kidneys fail to work properly,
waste products stay in the body, fluids build up and the chemical balance is upset. This is
called diabetic nephropathy.
You will not notice damage to your kidneys until it’s quite advanced, however early signs of
kidney problems can be detected through a urine test.
Finding out about early kidney damage is simple and painless and should be checked every
year from the time of diagnosis of diabetes. Treatment at this time can prevent further damage.
In severe kidney disease dialysis treatment or a kidney transplant may be needed.
People with diabetes are also at increased risk of infection of the bladder, kidneys and urinary tract.
The good news is that the risk of developing kidney problems can be reduced by: stopping
smoking if you smoke, managing your blood glucose levels, having regular kidney and blood
pressure checks and leading a healthy lifestyle.
74
16
ehl;gl;l rpf;fy;fs;
,uj;j FSNfh]; (rHf;fiu) msTfs; mjpf fhyj;Jf;F caHe;J ,Ug;gJ ePhpopT
Neha; rk;ge;jg;gl;l rpf;fy;fis cUthf;FfpwJ. mit fz; Neha;> rpWePuf
Neha;> euk;Gr; Nrjk;> ,itfSld; ,ja Neha; kw;Wk; ,uj;j Xl;lg; gpur;rpidfs;
Nghd;witfSk; cz;L. caH ,uj;j FSNfh]; msTfs; Neha;j; njhw;W
mghaj;ijAk; mjpfhpj;J> Neha;j; njhw;wpypUe;J Fzkhf;FtijAk; nkJthf;FfpwJ.
,f;fhuzq;fspdhy;> ePq;fs; cq;fs; ,uj;j FSNfh]; msTfis cq;fs; kUj;JtH
my;yJ ePhpopT Neha; Rfhjhug; guhkhpg;G FOtpdhy; ghpe;Jiuf;fg;gl;l tiuaiwf;F
cs;Ns ,Uf;FkhW Kaw;rp nra;tJ mtrpakhFk;.
ePhpopT NehAk;> fz; NehAk;:
ghHitf;F kpf mtrpakhd kpf Ez;zpa ,uj;j ehsq;fs; cs;s fz;zpd;
gpd;Gwj;ij (tpopj;jpiu) Nrjk; tpistpf;ff;$Lk;. ,J ePhpopT tpopj;jpiu Neha;
(diabetic retinopathy) vd;W miof;fg;gLk;. ePhpopT tpopj;jpiu Nehapd; tsHr;rp ePq;fs;
vt;tsT fhyk; ePhpopT Nehahy; ghjpf;fg;gl;bUf;fpwPHfs; kw;Wk; vt;tsT J}uk;
,uj;j FSNfh]; msTfs; fl;Lg;ghl;Lf;Fs; itf;fg;gl;bUf;fpd;wd vd;gdtw;Wld;
mjpfkhfr; rk;ge;jg;gl;Ls;sJ.
caH ,uj;j mOj;jk;> caH nfhOg;G epiyfs; kw;Wk; rpWePufr; nraypog;G
Nghd;witfs; $l ePhpopT tpopj;jpiu Nehapd; fLikiag; ghjpf;ff;$Lk;.
Muk;gepiyapNyNa fz;Lgpbf;fg;gl;L> rpfpr;ir mspf;fg;gLtjd; %yk;> ghHit
,og;G my;yJ FUl;Lj;jd;ik Nghd;wtw;iwj; jLf;f KbAk;.
ePhpopT tpopj;jpiuf;fhd rpfpr;irahdJ NyrH rpfpr;ir my;yJ mWitr;
rpfpr;irahf ,Uf;ff;$Lk;.
fpisNfhkh (Glaucoma) kw;Wk; fz;Giu (cataracts) Neha;fs; ,stajpNyNa
tuf;$Lk;. mj;Jld; mit ePhpopT NehAs;stHfSf;F mjpfkhf tuf;$Lk;.
fz;Giu (Cataracts) tpop tpy;iyiag; ghjpj;J mij Gifgbe;jik Nghy;
njsptw;wjhf;fp ghHitia ,of;f itj;J tpLk;. fz;Giuf;F rpfpr;ir Kiw
mWit rpfpr;irjhd;.
fpisNfhkh (Glaucoma) vd;gJ fz;Zf;Fs; mOj;jk; kpfTk; mjpfhpj;Jf; fz;
euk;igr; Nrjg;gLj;Jtjhy; NeHtjhFk;. fpisNfhkhTf;F rpfpr;ir Kiw fz;
nrhl;LkUe;J> NyrH rpfpr;ir my;yJ mWitr; rpfpr;ir MFk;.
ePhpopT NehAk;> rpWePuf NehAk;
cq;fs; rpWePufq;fs; cq;fs; ,uj;jj;ijr; Rj;jg;gLj;j cjTfpd;wd. mit
cq;fs; ,uj;jj;jpypUe;J fopTg; nghUl;fis ePf;fp> clypypUe;J rpWePuhf
ntspNaw;Wfpd;wd.
fhyg;Nghf;fpy; ePhpopT Neha; rpWePufq;fSf;F Nrjk; tpistpf;ff;$Lk;. rpWePufq;fs;
rhpahf Ntiy ghHf;fj; jtwpdhy;> fopTg; nghUl;fs; clypNyNa jq;fp> jputq;fs;
NrHe;JNgha;> ,urhadr; rkepiy ghjpf;fg;gLk;. ,J ePhpopT rpWePuf Neha; vd;W
miof;fg;gLk;.
cq;fs; rpWePufj;Jf;F Vw;gl;bUf;Fk; Nrjj;ij kpfTk; Kw;wpa epiyf;F mJ
tUk;tiu ePq;fs; ftdpf;fg; NghtJ ,y;iy. ,Ug;gpDk; rpWePufg; gpur;rpidfspd;
Muk;g milahsq;fisr; rpWePHg; ghpNrhjid %yk; njhpe;J nfhs;syhk;.
Muk;gfhyr; rpWePufg; gpur;rpidfisj; njhpe;Jnfhs;tJ vspikahdJ mj;Jld;
typapy;yhjJ. ePhpopT Neha; ,Uf;fpwJ vd;gijf; fz;lwpag;gl;l Neuk; Kjy;
xt;nthU tUlKk; fl;lhak; ghpNrhjid nra;J nfhs;s Ntz;Lk;. mr;rkaj;jpy;
nra;ag;gLk; rpfpr;ir NkYk; Nrjk; Vw;glhky; jLf;Fk;.
kpfTk; fLikahd rpWePuf Neha;f;F lahyprp]; rpfpr;ir my;yJ rpWePuf khw;Wr;
rpfpr;ir Njitg;glyhk;.
75
Chronic complications - continued
Diabetes and nerve disease:
Diabetes over time can cause damage to nerves throughout the body. This damage is
referred to as diabetic neuropathy.
Neuropathy leads to numbness, changes in sensation and sometimes pain and weakness in
the , feet, legs, hands and arms. Problems may also occur in the digestive tract, heart and sex
organs.
Diabetic neuropathy also appears to be more common in people who have:
• Problems controlling their blood glucose levels
• High levels of blood fat
• High blood pressure
• Excess weight
• An age greater than 40
• Had diabetes for a long time.
Signs and symptoms of nerve damage may include:
• Numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
• Muscle wasting of the feet or hands
• Indigestion, nausea, or vomiting
• Diarrhoea or constipation
• Feeling dizzy or faint due to a drop in blood pressure when standing
• Visual problems
• Problems with urination
• Erectile dysfunction (impotence) or vaginal dryness
• Sweating and palpitations
• Weakness
• Dry skin
• Dry mouth, eyes, nose.
Neuropathy can also cause muscle weakness and loss of reflexes, especially at the ankle,
leading to changes in the way the person walks. Foot deformities may occur. Blisters and
sores may appear on numb areas of the foot because pressure or injury goes unnoticed,
leading to the development of an ulcer. If foot injuries or ulcers are not treated quickly, the
infection may spread to the bone, and in extreme circumstances, may result in amputation.
Due to neuropathy and its effect on daily living the person may lose weight and is more likely
to suffer with depression.
The best way to minimise your risk for developing neuropathy is to keep your blood glucose
levels as close to the recommended range as possible. Daily foot care is of great importance
to reduce complications.
Treatment of neuropathy includes pain relief and other medications as needed, depending
on the type of nerve damage. Discuss the options with your health care team.
Diabetes and heart disease/stroke:
People with diabetes are at increased risk of heart disease and stroke. Higher than
recommended blood glucose and cholesterol levels and high blood pressure over long
periods of time damage the large blood vessels. This can lead to heart disease (coronary
artery disease), damage to the brain (cerebral artery disease) and other blood vessel disease
(peripheral artery disease).
Blood vessel disease is progressive and causes hardening and narrowing of the arteries due
to a gradual build up of plaque (fatty deposits).
Coronary artery disease is the most common form of heart disease. Blood carries oxygen and
76
ehl;gl;l rpf;fy;fs; - njhlUk;
ePhpopT Neha; cs;stHfSf;Fr; rpWePHg;ig> rpWePufk; kw;Wk; rpWePHf;Foha; Nghd;wtw;wpy;
Neha;j;njhw;W Vw;gLk; mghak; mjpfhpf;fpwJ.
ey;y nra;jp vd;dntd;why;> ePq;fs; Gifgpbg;gtuhf ,Ue;jhy;> Gifgpbg;gij epWj;jpdhy;>
cq;fs; ,uj;j FSNfh]; msTfis rhpahf epHtfpj;J te;jhy;> rpWePuf kw;Wk; ,uj;j
mOj;j Nrhjidfis xOq;fhf nra;J te;jhy;> mj;Jld; MNuhf;fpa tho;f;if Kiw
tho;e;J te;jhy;> rpWePufg; gpur;rpidfshy; Vw;gLk; mghaj;ijf; Fiwf;f KbAk;.
ePhpopT Neha; kw;Wk; euk;G tpahjpfs;
rpwpJ fhyj;jpy;> ePhpopT Neha; cly; KOtJk; cs;s euk;Gfisr; Nrjk; nra;af;$Lk;.
,e;j Nrjk; ePhpopT euk;G Neha; (diabetic neuropathy) vd;W nrhy;yg;gLfpwJ.
ePhpopT euk;G NehahdJ ghjq;fs;> fhy;fs;> iffs; kw;Wk; G[q;fspy; kuj;Jg; Nghjy;>
czHr;rpfspy; khw;wq;fs;> rpy Neuq;fspy; typ kw;Wk; gytPdk; Nghd;w gpur;rpidfSf;Ff;
nfhz;L nry;Yk;. czTf; Foha;> ,jak; kw;Wk; ghYWg;Gfs; Nghd;witfspYk;
gpur;rpidfs; Vw;glyhk;.
ePhpopT euk;G Neha; gpd;tUk; gpur;rpidfisf; nfhz;l egHfsplk; kpf mjpfkhf fhzg;gLk;:
• jq;fSila ,uj;j FSNfh]; msTfisf; fl;Lg;ghl;Lf;Fs; itj;jpUg;gjpy;
gpur;rpidfs;
• caH ,uj;jf; nfhOg;G msTfs; • caH ,uj;j mOj;jk;
• mjpf vil • 40 -f;F Nkw;gl;l taJ
• ePz;lfhy ePhpopT Neha;.
euk;G Nrjq;fspd; milahsq;fs; kw;Wk; mwpFwpfspy; gpd;tUgitfSk; mlq;Fk;:
• czHr;rpapd;ik> rpypHg;G my;yJ fhy;tpuy;fs;> ghjq;fs;> fhy;fs;> iffs;> G[q;fs;
kw;Wk; iftpuy;fspy; typ
• ghjq;fs; my;yJ iffspy; jir tPzhjy;
• m[Puzk;> Fkl;ly; my;yJ the;jp
• tapw;Wg;Nghf;F my;yJ kyr;rpf;fy;
• epd;Wnfhz;bUf;Fk;NghJ ,uj;j mOj;jk; Fiwtjhy; jiy Rw;Wfpw czHT my;yJ
kaf;fkiljy;
• ghHitf; NfhshWfs;
• rpWePH fopg;gjpy; gpur;rpidfs;
• tpiug;Gj; jd;ik nray; ,og;G (kyl;Lj;jd;ik) my;yJ ngz;ZWg;gpy; <ukpd;ik
• tpaHit kw;Wk; ,jag; glglg;G
• gytPdk;
• cyHe;j Njhy;
• cyHe;j tha;> fz;fs;> %f;F.
ePhpopT euk;G NehahdJ> jir gytPdk; kw;Wk; Fwpg;ghf fZf;fhypy; mdpr;irahd
vjpHtpidia cUthf;fp xUtH elf;Fk; tifiaNa khw;wptplf; $baJ. fhypy; Cdk;
Vw;glyhk;. mOj;jj;ijNah> fhaj;ijNah ftdpf;fhky; tpl;LtpLtjhy;> fhypy; czHr;rpaw;w
ghfq;fspy; nfhg;Gsq;fSk;> Gz;fSk; Njhd;wp ,Wjpapy; my;rhpy; nfhz;LNgha; tpl;LtpLk;.
fhy; fhaq;fNsh my;yJ my;rNuh cldbahfr; rpfpr;ir nra;ag;glhtpl;lhy; vYk;G tiu
Neha;j;njhw;W gutyhk;. ,f;fl;lhd #o;epiyfspy; fhiyj; Jz;bf;f Ntz;b tuyhk;.
ePhpopT euk;G Neha; kw;Wk; md;whl tho;f;ifapy; mjd; tpistpd; fhuzkhf xUtUf;F
vil Fiwayhk; kw;Wk; kdmOj;jj;jpdhy; ghjpf;fg;gLk; epiy Vw;glyhk;.
ePhpopT euk;G Neha; cUthFtjw;fhd mghaj;ijf; Fiwf;f kpfr;rpwe;j top cq;fs; ,uj;j
FSNfh]; msTfis ghpe;Jiuf;fg;gl;l tiuaiwf;F xl;b tUkhW itj;jpUg;gjhFk;.
jpde;NjhWk; ghjq;fisg; guhkhpg;gJ gpur;rpidfisf; Fiwg;gjw;F kpf Kf;fpakhdjhFk;.
ePhpopT euk;G Neha;f;fhd rpfpr;irapy; typ epthuzp kw;Wk; euk;Gr; Nrj tifiag;
nghWj;Jj; Njitg;gLk; kw;w kUe;J tiffSk; mlq;Fk;. njhpTfisg; gw;wp cq;fs;
Rfhjhug; guhkhpg;G FOtplk; fye;J MNyhrpj;Jf; nfhs;sTk;.
77
other important nutrients to your heart. Blood vessels to your heart can become partially or
totally blocked by fatty deposits. Chest pain (angina) or a heart attack occurs when the blood
flow supplying oxygen to your heart is reduced or cut off.
Over time, coronary artery disease can weaken the heart muscle and lead to heart failure
preventing the heart from pumping blood properly to the rest of the body. This can also lead
to abnormal beating rhythms of the heart.
A stroke occurs when blood supply to part of your brain is interrupted and brain tissue is
damaged. The most common cause is a blocked blood vessel. Stroke can cause physical
problems such as paralysis, problems with thinking or speaking, and emotional problems.
Peripheral artery disease occurs when blood vessels in your legs are narrowed or blocked
by fatty deposits causing reduced blood flow to your legs and feet.
Many people with diabetes and peripheral artery disease do not have any symptoms.
Other people may have the following symptoms:
• leg pain, particularly when walking or exercising, which disappears after a few minutes of rest
• numbness, tingling, or coldness in the lower legs or feet
• sores or infections on feet or legs that heal slowly.
Certain exercises, such as walking, can be used both to treat peripheral arterial disease and
to prevent it. Medications may help relieve symptoms. In advanced cases treatment may
involve surgical procedures.
You can lower your risk of blood vessel damage by keeping your blood glucose, blood
pressure and cholesterol in the recommended range with healthy eating, physical activity,
and medication. Quitting smoking is essential to lower your risk.
Diabetes and infection:
High blood glucose levels can lower your resistance to infection and can slow the healing
process.
Oral health problems and diabetes
When diabetes is not controlled properly, high glucose levels in saliva may increase the
amount of bacteria in the mouth and may also cause dryness of the mouth. Blood glucose
(sugar) levels that stay high for long periods of time reduces the body’s resistance to
infection, and the gums are likely to be affected.
Periodontal diseases are infections of the gums and bones that hold your teeth in place. Even
if you wear dentures, you should see your dentist at least once a year.
Signs and symptoms of oral health problems include:
• Gums that are red and swollen, or that bleed easily
• Persistent bad breath or bad taste in the mouth
• Any change in the fit of dentures.
Fungal infections /Thrush
Thrush is the term used for a common infection caused by a yeast-like fungus.
Yeast infections are often associated with diabetes, especially when the blood glucose level is
very high. Persistent cases of thrush may sometimes be an early sign of diabetes.
Thrush can occur in the mouth, throat, digestive tract, vagina or on the skin. It thrives in the
moist areas of the body.
Oral thrush, a fungal infection in the mouth, appears to occur more frequently among people
with diabetes including those who wear dentures. Thrush produces white (or sometimes red)
78
ePhpopT Neha; kw;Wk; ,jaNeha;/gf;fthjk;
ePhpopT Neha; cs;stHfs; ,jaNeha; kw;Wk; gf;fthjj;jhy; ghjpf;fg;gLk; mghaj;Jf;F
mjpfk; cs;shfpwhHfs;. ghpe;Jiuf;fg;gl;l msTf;F Nky; ,uj;j FSNfh]; kw;Wk; nfhOg;G
msTfs; kw;Wk; caH ,uj;j mOj;jk; ePz;l fhyk; ePbj;jhy; nghpa ,uj;jf; Foha;fisr;
Nrjk; nra;Ak;. ,J ,ja Neha; (,jaj; jkdp Neha;)> %isr; Nrjhuk; (ngU%isj; jkdp
Neha;) kw;Wk; NtW ,uj;jf; Foha; Neha; (Gwj; jkdp Neha;) Nghd;witfSf;F ,l;Lr;
nry;Yk;.
,uj;jf; Foha; Neha; vd;gJ tsHe;J nfhz;bUf;Fk; Neha;. NkYk; nfhQ;rk; nfhQ;rkhf
fhiu gbtjd; (nfhOg;Gg; gbTfs;) fhuzkhfj; jkdpfis fbdg;gLj;jp> FWfyhf;FfpwJ.
,jaj; jkdp Neha; (Coronary artery disease) vd;gJ nghJthf fhzg;gLfpd;w ,jaNehahFk;.
,uj;jk; Mf;]p[idAk;> Kf;fpa Cl;lr;rj;Jf;fisAk; cq;fs; ,jaj;Jf;F vLj;Jr;
nry;fpwJ. cq;fs; ,jaj;Jf;Fr; nry;Yk; ,uj;j ehsq;fs; nfhOg;Gg; gbTfshy;
XusTf;Nfh> KOtJkhfNth milg;G Vw;gLj;jf;$Lk;. cq;fs; ,jaj;Jf;F Mf;]p[d;
toq;Ffpd;w ,uj;j Xl;lk; Fiwe;jhNyh my;yJ jilg;gl;lhNyh neQ;Rtyp (angina)
my;yJ khuilg;G Vw;gLk;.
fhyg;Nghf;fpy;> ,jaj; jkdp Neha; ,jaj; jirfis gytPdg;gLj;jp> ,jak;
clypd; gpw ghfq;fSf;F ,uj;jk; xOq;fhff; nfhz;L nry;tijj; jLj;J Kbtpy;
,jar; nraypog;Gf;F ,l;Lr; nry;Yk;. mj;Jld; mrhjhuzkhd ,jaj; Jbg;Gf;Fk;
nfhz;L nrd;Wtplf;$Lk;.
cq;fSila xU gFjp %isf;Fr; nry;Yk; ,uj;j Xl;lk; ghjpf;fg;gl;L %isj;
jpRf;fs; NrjkilAk;NghJ gf;fthjk; (stroke) Vw;gLfpwJ. milgl;l ,uj;j
ehsk;jhd; ,jw;F kpfg; nghJthd fhuzkhFk;. Klf;Fthjk; Nghd;w cly;hPjpahd
gpur;rpidfs;> rpe;jpg;gjpNyh> NgRtjpNyh gpur;rpidfs; kw;Wk; czHTG+Htkhd
gpur;rpidfis gf;fthjk; cUthf;ff;$Lk;.
Gwj; jkdp Neha; (Peripheral artery disease) vd;gJ cq;fs; fhy;fspy;
cs;s ,uj;j ehsq;fs; nfhOg;Gg; gbtq;fshy; FWfyhFk;NghNjh my;yJ
milgLk;NghNjh Vw;gLfpwJ. ,J cq;fs; fhy;fSf;Fk;> ghjq;fSf;Fk; ,uj;j
Xl;lk; Fiwaf; fhuzkha; ,Uf;fpwJ.
ePhpopT NehAk;> Gwj; jkdp NehAk; cs;s gyUf;F ve;j mwpFwpfSk; ,Uf;fhJ.
kw;wtHfSf;F gpd;tUk; mwpFwpfs; ,Uf;fyhk;:
• fhy;typ> Fwpg;ghf elf;Fk;NghJk;> clw;gapw;rp nra;Ak;NghJk; ,Uf;Fk;. rpwpJ
epkpl Xa;Tf;Fg; gpd; kiwe;J tpLk;.
• czHr;rpapd;ik> rpypHg;G my;yJ fhy;fspd; fPo;ghfj;jpy; my;yJ ghjq;fspy;
FspHr;rpahd czHT
• ghjq;fspy; my;;yJ fhy;fspy; cs;s Gz;fs; my;yJ Neha;j; njhw;W nkJthff;
Fzkiljy;.
elj;jy; Nghd;w rpy clw;gapw;rpfs; Gwj; jkdp Nehiaf; Fzg;gLj;jTk;> mijj;
jLf;fTk; cjtf;$Lk;. kUe;J tiffs; Neha; mwpFwpfspy; ,Ue;J tpLtpf;ff;$Lk;.
Kw;wpa epiyf;F mspf;fg;gLk; rpfpr;irapy; mWitr; rpfpr;ir KiwfSk; mlq;Fk;.
cq;fs; ,uj;j FSNfh];> ,uj;j mOj;jk; kw;Wk; nfhOg;G msTfis MNuhf;fpa
czT> cly; nray;ghLfs; kw;Wk; kUe;J tiffs; %yk; ghpe;Jiuf;fg;gl;l
tiuaiwf;Fs; itj;jpUe;jhy; ePq;fs; ,uj;;j ehsr; Nrj mghaj;ijf; Fiwf;f
KbAk;. cq;fs; mghaj;ijf; Fiwf;fg; Gifgpbj;jiy epWj;Jjy; kpfTk;
mtrpakhFk;.
79
patches in the mouth. It may cause a painful, burning sensation on your tongue. It can affect
your ability to taste foods and may make it difficult for you to swallow.
In women, vaginal thrush is a very common infection. A common symptom is itching and
soreness around the vagina.
Urinary tract infections are more common in people with diabetes. They are caused by
micro-organisms or germs, usually bacteria.
Signs and symptoms include:
• Wanting to urinate more often, if only a few drops
• Strong smelling and cloudy urine
• Burning pain or a ‘scalding’ sensation on urination
• A feeling that the bladder is still full after urination
• Blood in the urine.
It is important to see your doctor immediately if any infection is suspected.
80
ePhpopT NehAk;> Neha;j; njhw;Wk;:
caH ,uj;j FSNfh]; msTfs; cq;fs; Neha;j; njhw;Wf;fhd vjpHg;Gr; rf;jpiaf;
Fiwj;J> Fzg;gLj;Jk; nraiy nkJthf;FfpwJ.
tha;r; Rfhjhug; gpur;rpidfSk;> ePhpopT NehAk;
ePhpopT Neha; rhpahd Kiwapy; fl;Lg;gLj;jg;gltpy;iynad;why;> ckpo;ePhpYs;s caH
FSNfh]; msTfs; thapYs;s ghf;Bhpahf;fis mjpfg;gLj;jp> thapy; cyHTj; jd;ikia
cz;lhf;fyhk;. mjpf fhyk; njhlHe;J ,uj;j FSNfh]; (rHf;fiu) msTfs; caHe;J
,Ug;gJ clypd; Neha; vjpHg;Gr; rf;jpiaf; Fiwf;fpwJ. mjdhy; <Wfs; ghjpf;fg;gLk;
tha;g;Gfs; cs;sd.
Periodontal diseases vdg;gLk; <W rk;ge;jg;gl;l Neha;fs; cq;fs; gw;fis epiyahfg;
nghUj;jpapUf;Fk; <WfspYk;> vYk;GfspYk; Vw;gLfpd;w Neha;j; njhw;whFk;. ePq;fs;
ngha;g;gw;fs; fl;bapUe;jhYk;> cq;fs; gy; kUj;Jtiu Fiwe;j gl;rk; tUlj;Jf;F xU
KiwahtJ fl;lhak; ghHf;f Ntz;Lk;.
tha;r; Rfhjhug; gpur;rpidfspd; milahsq;fs; kw;Wk; mwpFwpfspy; gpd;tUgitfSk;
mlq;Fk;:
• rpte;j kw;Wk; tPq;fpa <Wfs; my;yJ Rygkhf ,uj;jk; tbAk; <Wfs;
• neba> JHehw;wKs;s Rthrk; my;yJ thapy; nfl;l Rit
• ngha;g;gw;fs; nghUe;Jtjpy; VjhtJ khw;wk;.
G+Q;ir Neha;j;njhw;W/Gz;
<];l; Nghd;w G+Q;irapdhy; Vw;gLk; nghJthd njhw;W Neha;f;Fg; Gz; vd;w ngaH
gad;gLj;jg;gLfpwJ.
<];l; njhw;W Neha; nghJthf ePhpopT NehAld; njhlHGilajhf> Fwpg;ghf ,uj;j
FSNfh]; msT kpf mjpfkhFk;NghJ ,Uf;Fk;. njhlHe;J Vw;gLfpd;w Gz;fs; rpy
Neuq;fspy; ePhpopT Neha;f;F Muk;gfhy milahskhf ,Uf;fyhk;.
thapy;> njhz;ilapy;> czTf; Fohapy;> ngz; me;juq;f cWg;gpy; my;yJ Njhypd; Nky;
Gz; cz;lhff;$Lk;. clypd; <ukhd gFjpfspy; mJ nropj;Jg; ngUFfpwJ.
tha;g;Gz;> thapy; tsUk; G+Q;ir Neha;j; njhw;whFk;. ,J ngha;g;gy; fl;bapUg;gtHfs;
cl;gl ePhpopT Neha; cs;stHfSf;F mbf;fb Vw;gLk;. thapy; nts;is (my;yJ rpy
rkak; rptg;G) gl;ilfisg; Gz; cUthf;FfpwJ. mJ cq;fs; ehf;fpy; typkpFe;j>
vhpr;ryhd czHtpidj; juyhk;. mJ czit Urp ghHf;Fk; jpwidg; ghjpf;ff;$Lk;.
mj;Jld; tpOq;Ftjw;Fk; rpukj;ij Vw;gLj;jf;$Lk;.
ngz;fSf;F me;juq;f cWg;gpy; Gz; vd;gJ nghJthd Neha;j; njhw;whFk;. ngz;Fwpiar;
Rw;wp mhpg;Gk;> ,uzKk; nghJthd mwpFwpahFk;.
rpWePHf; Foha; Neha;j; njhw;W vd;gJ ePhpopT Neha; cs;stHfSf;F mbf;fb
Vw;gLtjhFk;. mJ Ez;Zaphpfshy; my;yJ ghf;Bhpah Nghd;w fpUkpfshy; cz;lhfpwJ.
milahsq;fs; kw;Wk; mwpFwpfspy; gpd;tUgitfSk; mlq;Fk;:
• mbf;fb rpWePH fopf;Fk; ce;Jjy;> mJTk; XhpU Jspfs; kl;Lk;
• fLikahfj; JHehw;wk; tPRk; kw;Wk; fyq;fyhd rpWePH
• rpWePH fopf;Fk;NghJ vhpr;rYld; $ba typ my;yJ ‘#l;Lld;’ $ba czHT
• rpWePH fopj;j gpd;Gk; rpWePHg;ig epiwe;jpUg;gijg; Nghy czHT
• rpWePhpy; ,uj;jk;.
,e;Neha;j; njhw;W ,Ug;gjhf cq;fSf;Fr; re;Njfk; vJTk; ,Ue;jhy; cq;fs; kUj;Jtiug;
ghHg;gJ mtrpakhFk;.
81
17
Diabetes and your Feet
Diabetes may affect the feet in two ways.
Firstly, nerves which allow you to feel pain, temperature and give an early warning of possible
injury, can be damaged.
Secondly, the blood supply to the feet can be reduced due to blockage of the blood vessels.
Damage to the nerves and blood vessels is more likely if you have had diabetes for a long
time, or if your blood glucose (sugar) levels have been too high for too long.
It is recommended that people with diabetes should be assessed by a podiatrist or doctor at
least every six months. They will advise a common sense, daily care routine to reduce the risk
of injuries and complications.
It is also essential to check your feet every day for any problems.
Caring for your feet
• Maintain blood glucose levels within the range advised by your doctor
• Help the circulation to your feet with some physical activity like walking
• Know your feet well
– Look at your feet daily. Use a mirror if you need to. Check between your toes
– Wash your feet daily in warm (not hot) water, using a mild soap. Dry gently and thoroughly
– Never soak your feet
– Use a moisturiser to avoid dry skin
– Only cut your toenails if you can do so safely. Cut straight across – not into the corners –
and gently file away any sharp edges.
• Choose footwear which is appropriate for your activity. Smooth out wrinkles in socks
• Check your shoes regularly for excess wear on the outside and for any rough spots on the
inner lining
• Avoid foot injuries by wearing shoes or slippers around the house and footwear at the
beach or pool
• Avoid contact with very hot or cold items, such as hot water bottles, heaters, electric
blankets, hot sand/pathways and hot bath water
• Wear insulated boots to keep feet warm on cold days
• Corn cures and medicated pads can burn the skin. Do NOT treat corns yourself - see your
podiatrist
• Get medical advice early if you notice any change or problems with your feet.
82
17
ePhpopT NehAk;> cq;fs; ghjq;fSk;
ePhpopT Neha; ghjq;fis ,uz;L tiffspy; ghjpf;fyhk;.
Kjyhtjhf> typ> ntg;gk; Nghd;wtw;iw czuitj;J> fhak; Vw;gLtjw;fhd
tha;g;gpidg; gw;wp Kd;$l;bNa vr;rhpf;if jUfpd;w euk;Gfs; ghjpf;fg;glf;$Lk;.
,uz;lhtjhf> ,uj;j ehsq;fspy; milg;gpd; fhuzkhf ghjq;fSf;Fg; ghAk; ,uj;j
Xl;lk; Fiwaf;$Lk;.
cq;fSf;F ePz;lfhyk; ePhpopT Neha; ,Ue;jhNyh> my;yJ cq;fs; ,uj;j
FSNfh]; (rHf;fiu) msTfs; ePz;lfhyj;Jf;F kpf mjpfkhf ,Ue;jhNyh>
euk;Gfs; kw;Wk; ,uj;j ehsq;fspy; Nrjk; Vw;gLtjw;fhd rhj;jpaf;$Wfs; mjpfk;
cz;L.
ePhpopT Neha; cs;stHfs; ghj rpfpr;ir epGzH my;yJ kUj;Jtuhy; Fiwe;jgl;rk;
MW khjq;fSf;F xUKiw kjpg;gPL nra;ag;gl Ntz;Lnkd ghpe;Jiuf;fg;gLfpwJ.
mtHfs; fhaq;fs; kw;Wk; rpf;fy;fs; cUthFk; mghaj;ijf; Fiwf;fg; nghJ mwpT
rhHe;j> md;whlg; guhkhpg;Gf;fhd mwpTiu toq;FtH.
ve;j gpur;rpidfSf;Fk;> cq;fs; ghjq;fisg; ghpNrhjpg;gJk; mtrpakhFk;.
cq;fs; ghjq;fisg; guhkhpj;jy;
• cq;fs; kUj;Jthpd; MNyhridg;gb ,uj;j FSNfh]; msTfis
tiuaiwf;Fs; guhkhpf;fTk;
• elg;gJ Nghd;w rpy cly; nray;ghLfs;> cq;fs; ghjq;fspy; ,uj;j Xl;lk;
eilngw cjTfpwJ
• cq;fs; ghjq;fisg; gw;wp ed;F mwpe;J nfhs;Sq;fs;
• jpdKk; cq;fs; ghjq;fisf; ftdpAq;fs;. Njitg;gl;lhy; fz;zhb xd;iwg;
gad;gLj;jTk;. fhy;tpuy;fSf;fpilNa ghpNrhjpf;fTk;
• jpdKk; cq;fs; ghjq;fis nkd;ikahd Nrhg; cgNahfpj;J> ntJntJg;ghd
(#lhdJ my;y) ePhpdhy; fOtTk;. mjd;gpd; nkd;ikahfTk;> KOikahfTk;
cyuitf;fTk;
• cq;fs; ghjq;fis Cwitf;ff; $lhJ
• cyHe;j Njhiyj; jtpHf;f <ug;girj; jputj;ij (moisturiser) cgNahfpf;fTk;
• cq;fshy; ghJfhg;ghf nra;aKbAnkd;why; kl;LNk cq;fs; fhy;tpuy; efq;fis
ntl;lTk;. FWf;fhf ntl;lTk; - Xuq;fis ntl;l Ntz;lhk; - $Hikahd
Xuq;fis nkd;ikahf uhtp tplTk;.
• cq;fSila nray;ghLfSf;Fj; jf;f khjphpahd fhyzpiaj; NjHe;njLj;Jf;
nfhs;sTk;. fhYiwfspy; cs;s RUf;fq;fis ePf;fpf; nfhs;sTk;
• cq;fSila nrUg;Gf;fspd; ntspg;Gwj;jpy; Vw;gLk; mjpfg;gbahd
Nja;khdj;ijAk;> cs;Gwj;jpy; vJTk; fuLKulhd ,lq;fisAk; jtwhky;
rhpghHj;Jf; nfhs;sTk;
• tPl;Lf;Fs; nrUg;GfisNah> kpjpabiaNah> flw;fiuapy; my;yJ ePr;ry; Fsj;jpy;
fhyzpfisNah mzpe;J fhypy; fhaq;fisj; jtpHf;fTk;
• ntd;dPH ghl;by;fs;> `Pl;lHfs;> kpd; fk;gsq;fs;> RLkzy;/eil ghij kw;Wk;
ntd;dPHf; Fspay; Nghd;w kpfr; #lhd my;yJ FspHe;j nghUl;fisj;
njhLtijj; jtpHf;fTk;
• FspHe;j ehl;fspy; ghjq;fis ntJntJg;ghf itj;Jf; nfhs;tjw;F ntg;gk;
flj;jhr; nrUg;Gfisg; NghlTk;
• fhy; Mzp kUe;J> kUe;jilj;j jpz;Lfs; Nghd;wit Njhiy vhpj;Jtplf;$Lk;.
fhy; Mzpf;F ePq;fNs rpfpr;ir mspj;Jf; nfhs;s Ntz;lhk;. – ghj rpfpr;ir
epGziug; ghHf;fTk;
• cq;fs; ghjq;fspy; ve;j tpjkhd khw;wj;ijg; ghHj;jhNyh my;yJ
gpur;rpidfsg; ghHj;jhNyh cldbahf kUj;Jt MNyhrid ngwTk;.
83
18
Diabetes and Pregnancy
The key to a healthy pregnancy for a woman with diabetes is
planning, Before you become pregnant discuss your target blood
glucose levels or other pregnancy issues with your doctor or
diabetes educator.
Note: the target blood glucose levels are tighter during pregnancy.
You will need a diabetes management plan that balances meals,
physical activity and diabetes medication (usually insulin).
This plan will change as your body changes during your pregnancy.
If your pregnancy is unplanned it is important to work with your
medical team as soon as you know you are pregnant.
Why you need to keep your blood glucose levels within the
recommended range for pregnancy
Having good blood glucose management reduces the risk of the baby having any
abnormalities when all of its organs are being formed in the first 12 weeks of pregnancy. As
your pregnancy progresses, it is very important that you maintain good blood glucose levels
otherwise extra sugar in your blood will pass to the baby who can then become big. Delivery
of big babies can cause problems.
Who will help you before, during and after your pregnancy?
Apart from your diabetes health care team, other health professionals that will support you
are:
• an obstetrician (a specialist doctor that looks after pregnant women)
• a neonatal paediatrician (a specialist doctor that looks after babies)
• a midwife (a nurse, who assists women in childbirth).
Exercise, especially for people with type 2 diabetes, is a key part of diabetes management
before, during and after pregnancy.
Discuss your exercise plans with your diabetes health care team.
In general, it’s not a good idea to start a new strenuous exercise program during pregnancy.
Good exercise choices for pregnant women include walking, low-impact aerobics or
swimming.
84
18
ePhpopT NehAk;> fUj;jhpg;Gk;
ePhpopT Neha; cs;s ngz;fSf;Fr; Rfg;gpurtj;Jf;fhd
mbg;gilf; fhuzk; jpl;lkpLjy; MFk;. ePq;fs; fUj;jhpg;gjw;F
Kd;Ng cq;fsJ ,uj;j FSNfh]; msTfspd; ,yf;F
my;yJ kw;w fUj;jhpg;Gg; gpur;rpidfis cq;fs; kUj;JtH
my;yJ ePHpopT Neha; fy;tpahshplk; fye;jhNyhrpj;Jf;
nfhs;Sq;fs;.
Fwpg;G: fHg;g fhyj;jpy; ,uj;j FSNfh]; msTfspd; ,yf;F
FWfpajhf ,Uf;Fk;.
rj;JzT> cly; nray;ghL kw;Wk; ePhpopT Neha; kUe;J
tiffs; (nghJthf ,d;Rypd;) Nghd;w ePhpopT Neha; epHthfj;
jpl;lk;; cq;fSf;Fj; NjitahapUf;Fk;.
fUj;jhpg;Gf; fhyj;jpy; cq;fs; cly; khWjyiltjhy; ,e;jj;
jpl;lj;;jpYk; khWjy; ,Uf;Fk;.
cq;fs; fHg;gk; jpl;lkplg;glhjpUe;jhy;> ePq;fs; fUj;jhpg;gJ njhpe;jTlNd cq;fs;
kUj;Jtf; FOTld; ,ize;J nrayhw;WtJ mtrpakhFk;.
fUj;jhpg;Gf; fhyj;jpy; cq;fs; ,uj;jf; FSNfh]; msTfisg; ghpe;Jiuf;fg;gl;l
tiuaiwf;Fs; Vd; itj;jpUf;f Ntz;Lk;
rpwe;j ,uj;j FSNfh]; epHthfk;> Foe;ijf;F vy;yh cWg;GfSk;> Kjy; 12 thuf;
fHg;gj;jpy; cUthfp tUk;NghJ> Foe;ij mrhjhuzf; FiwghLfSld; gpwf;Fk;
mghaj;ijf; Fiwf;fpwJ. cq;fs; fHg;gfhy ehl;fs; nry;yr; nry;y> rpwe;j ,uj;j
FSNfh]; msTfis ePq;fs; guhkhpg;gJ kpf mtrpakhfpwJ. ,y;yhtpby; cq;fs;
,uj;jj;jpy; cs;s mjpf mstpyhd rHf;fiu Foe;ijf;Fr; nrd;wile;J mJ
mstpy; nghpajhfp tpLk;. Foe;ij nghpajha; ,Ue;jhy; gpwg;gpy; gpur;rpidfs;
cUthff;$Lk;.
fUj;jhpg;Gf;F Kd;Dk;> fUj;jhpg;G rkaj;jpYk; kw;Wk; fUj;jhpg;Gf;Fg; gpd;Dk; ahH
cq;fSf;F cjtp nra;thHfs;?
ePhpopT Neha; Rfhjhug; guhkhpg;Gf; FOitj; jtpu cq;fSf;F cjtpGhpAk; kw;w
Rfhjhug; gzpty;YeHfs; gpd;tUkhW:
• gpurt kUj;JtH (fUj;jhpj;j ngz;fisf; ftdpf;Fk; rpwg;G kUj;JtH)
• gpwe;j Foe;ij kUj;JtH (Foe;ijfisf; ftdpf;Fk; rpwg;G kUj;JtH)
• kUj;Jtr;rp (Foe;ij gpwg;gpy; cjtp GhpAk; jhjp)
ePhpopT Neha; epHthfj;jpy;> fUj;jhpg;Gf;F Kd;Dk;>
fUj;jhpg;G rkaj;jpYk; kw;Wk; fUj;jhpg;Gf;Fg;
gpd;Dk; clw;gapw;rp> mjpYk; Fwpg;ghf ePhpopT
Neha; tif 1-My; ghjpf;fg;gl;bUg;gtHfSf;F>
kpf Kf;fpa gq;F tfpf;fpwJ.
cq;fs; clw;gapw;rpj;; jpl;lq;fis ePhpopT Neha;
Rfhjhug; guhkhpg;Gf; FOtplk; fye;jhNyhrpf;fTk;.
nghJthf fHg;gfhyj;jpy; Gjpa fLikahd
clw;gapw;rpiaj; njhlq;FtJ ey;yJ my;y.
fUj;jhpj;j ngz;fSf;fhd ey;y clw;gapw;rpfspy;
eilg;gapw;rp> kpjkhd %r;Rg;gapw;rp my;yJ ePr;ry; Mfpait mlq;Fk;.
85
19
Diabetes and your emotions
Chronic diseases such as diabetes can have a major impact on
your emotions because they affect every aspect of your life.
The physical, mental or emotional reactions to the diagnosis of
diabetes and the ability to cope may impact on your diabetes,
your family, your friends and your work colleagues.
When a person is diagnosed and living with diabetes there can
be many emotions that may be experienced. These include:
• Guilt
• Frustration
• Anger
• Fear
• Anxiety
• Depression
Many people do not like the idea that they may have mental or
emotional problems. Unfortunately, they find it embarrassing or
view it as a weakness. Having diabetes increases your risk
of developing depression. Tell your doctor how you feel.
If you feel you are more comfortable talking with other
members of your diabetes health care team such as a
diabetes educator or podiatrist, talk to them.
You need to tell someone. Then you will be referred to
the right person who can help you move in the right
direction.
Recommended websites:
www.australiandiabetescouncil.com
www.beyondblue.org.au
www.diabetescounselling.com.au
www.blackdoginstitute.org.au
86
19
ePhpopT NehAk;> cq;fs; czHr;rpfSk;
ePhpopT Neha; Nghd;w ehl;gl;l tpahjpfs; cq;fs;
czHr;rpfspy; xU nghpa jhf;fj;ij cz;L gz;z
KbAk;. Vndd;why; mit cq;fs; tho;f;ifia xt;nthU
epiyapYk; ghjpf;fpd;wd.
ePhpopT Neha; vdf; fz;lwpag;gl;lTld; Vw;gLk; cly;>
kdk; my;yJ czHr;rpj; jhf;fq;fs; kw;Wk; mtw;iw
<LnfhLf;Fk; jpwd; Mfpait cq;fs; ePhpopT Nehia>
cq;fs; FLk;gj;ij> cq;fs; ez;gHfis kw;Wk;
cq;fSld; Ntiy ghHg;gtHfisj; jhf;fk; nra;ayhk;.
xUtUf;F ePhpopT Neha; ,Uf;fpwnjd fz;lwpag;gl;L>
mjDld; thOk; #o;epiyapy;> mjpfkhd czHr;rpfis
mDgtpf;f Ntz;bajpUf;fyhk;. mtw;Ws; gpd;tUgit
mlq;Fk;:
•Fw;w czHT
•tpuf;jp
•
•
•
•
Nfhgk;
gak;
gjl;lk;
kd mOj;jk;.
gyH jq;fSf;F kdk; rhHe;j kw;Wk; czHTG+Htkhd
gpur;rpidfs; ,Ug;gij tpUk;Gtjpy;iy.
JujpU~;ltrkhf> mtHfs; mij jHkrq;flkhdJ
vd vz;Zfpd;wdH my;yJ xU gytPdk;
vd;W ghHf;fpd;wdH. ePhpopT Neha; ,Ug;gJ kd
mOj;jj;ij mjpfhpf;Fk; mghaj;ijf; nfhz;Ls;sJ.
ePq;fs; vt;thW czHfpwPHfs; vd;gij kUj;Jthplk;
$Wq;fs;. ePq;fs; ePhpopT Neha; fy;tpahsH my;yJ
ghj rpfpr;ir epGzH Nghd;w cq;fs; ePhpopT Neha;
Rfhjhug; guhkhpg;Gf; FOtpd; kw;w cWg;gpdHfSld;
NgRtij mjpf nrsfhpakhdjhf czHtPHfshdhy;>
mtHfSld; NgrTk;.
ePq;fs; ahhplkhtJ ,ijr; nrhy;y Ntz;Lk;.
mjd;gpd; ePq;fs; rhpahd jpirapy; nry;y cjtp Ghpaf;$ba xU rhpahd eghplk;
ePq;fs; mDg;gp itf;fg;gLtPHfs;.
ghpe;Jiuf;fg;gl;l ,izajsq;fs;:
www.australiandiabetescouncil.com
www.beyondblue.org.au
www.diabetescounselling.com.au
www.blackdoginstitute.org.au
87
20
Diabetes and driving
High or low blood glucose (sugar) levels in people with diabetes can affect their ability
to drive safely. People with diabetes may have developed complications such as vision
problems, heart disease or nerve damage, which also can affect driving ability. It is vital that
people with diabetes know what to do in order to keep themselves and others safe while on
the road.
Austroads, the road transport and traffic safety
authority for Australia and New Zealand, has
developed guidelines for doctors to help assess their
patient’s fitness to drive. Diabetes and cardiovascular
disease are just two of the many conditions for which
there are specific medical standards and guidelines
which must be met for licensing and insurance.
The main concern when driving is a low blood
glucose (sugar) level. It can affect a driver’s ability to
react and concentrate. Low blood glucose can also
cause changes in consciousness which could lead to
losing control of the vehicle. People who are taking
certain diabetes medication and/or insulin are at risk
of hypoglycaemia.
Ask your doctor or diabetes educator if you are at risk.
Hyperglycaemia or high blood glucose levels can also affect driving ability as it can cause
blurred vision, fatigue and decreased concentration.
Medical Standards for Licensing
Private and Commercial – People with diabetes who are managed without medication do
not need to notify the Drivers Licensing Authority and may drive without license restriction.
However, they should be reviewed regularly by their doctor for progression of the disease.
Private Licence – People with diabetes who are managed with medication, but not insulin,
and do not have any diabetes complications do not need to notify the Drivers Licensing
Authority. They need to be reviewed every five years (meeting all other Austroads criteria). If
you do have any acute or chronic complications a conditional licence may be granted after
review by your treating doctor.
Commercial Licence – People with diabetes who are managed with medication, but not
insulin, need to notify the Drivers Licensing Authority in person. A conditional driver’s
licence may be granted subject to the opinion of the specialist, the nature of the driving task
and at least an annual review (meeting all other Austroads criteria)
Private Licence – People with diabetes who are managed with insulin need to notify the
Drivers Licensing Authority in person. A conditional licence may be granted subject to the
opinion of the specialist/treating doctor, the nature of the driving task and at least a two
yearly review (meeting all other Austroads criteria)
88
20
ePhpopT NehAk;> thfdk; Xl;LjYk;
ePhpopT Neha; cs;stHfSf;F caHe;j my;yJ Fiwe;j ,uj;j FSNfh];
(rHf;fiu) msTfs; mtHfs; ghJfhg;ghf thfdk; Xl;Lk; jpwikiag; ghjpf;ff;$Lk;.
ePhpopT Nehahy; ghjpf;fg;gl;ltHfSf;Fg; ghHitf; NfhshWfs;> ,ja Neha; my;yJ
euk;Gr; Nrjk; Nghd;w rpf;fy;fs; tsHe;J mjdhy; mtHfspd; thfdk; Xl;Lk; jpwik
ghjpf;fg;glyhk;. ePhpopT NehAs;stHfs; rhiyapy; gazpf;Fk;NghJ jq;fisAk;>
kw;wtHfisAk; ghJfhf;f vd;d nra;a Ntz;Lnkd mwpe;J nfhs;tJ mtrpakhFk;.
“Austroads” vd;W nrhy;yg;gLk; M];jpNuypa
kw;Wk; epA+rpyhe;J rhiyg; Nghf;Ftuj;J
kw;Wk; Nghf;Ftuj;Jg; ghJfhg;G Mizak;>
kUj;JtHfSf;fhf topfhl;ly;fis
cUthf;fpapUf;fpwJ. mit mtHfspd;
Nehahspfspd; thfdk; Xl;Lk; jFjpia kjpg;gPL
nra;a cjTfpd;wd. thfd chpkk; kw;Wk;
fhg;GWjp ngWtjw;fhd jFjp ngw Fwpg;gpl;l
kUj;Jtj; juf;fl;Lg;ghLfs; kw;Wk; topfhl;ly;fs;
nfhLf;Fk; gy epge;jidfspy; ,uz;L ePhpopT
Neha; kw;Wk; ,ja ehs Neha; kl;LNk.
thfdk; Xl;Lk;NghJ Vw;gLk; Kf;fpa ftiy
Fiwe;j ,uj;j FSNfh]; msthFk;. mJ
Xl;Lehpd; nray;ghl;Lj; jpwidAk;> xUKfg;gLj;Jk; jd;ikiaAk; ghjpf;ff;$Lk;.
Fiwe;j ,uj;j FSNfh]; Raepidtpy; khw;wj;ij Vw;gLj;jp mjd; tpisthf
thfdk;; nrYj;Jtjpy; fl;Lg;ghl;il ,of;f Nehplyhk;. rpy ePhpopT Neha; kUe;J
tiffis kw;Wk; /my;yJ ,d;Rypid vLf;Fk; kf;fs; i`NghfpisrPkpah Neha;f;F
MshFk; mghaj;jpy; cs;sdH.
ePq;fs; mt;tpj mghaj;jpy; ,Uf;fpwPHfsh vd;gij cq;fs; kUj;JtH my;yJ
ePhpopT Neha; fy;tpahshplk; NfSq;fs;.
i`gHfpisrPkpah my;yJ caH ,uj;j FSNfh]; msTfSk; thfdk; Xl;Lk;
jpwidg; ghjpf;ff;$Lk;. Vndd;why; mJ ghHit kq;fy;> kdr;NrhHT kw;Wk;
Fiwfpd;w xUKfr; rpe;jid Nghd;wtw;iw Vw;gLj;jf; $Lk;.
chpkk; ngw kUj;Jtj; juf;fl;Lg;ghLfs;
jdpahH kw;Wk; tHj;jfk; – kUe;J tiffs; ,y;yhky; rkhspf;ff;$ba ePhpopT
NehAs;stHfs;> Xl;LeH chpk Mizaj;jplk; njhptpf;f Ntz;bajpy;iy. mj;Jld;
chpkf; fl;Lg;ghL vJTkpd;wp thfdk; Xl;lyhk;. ,Ug;gpDk;> Nehapd; Kd;Ndw;wj;ijf;
fzpf;f mtHfs; jq;fs; kUj;Jtuhy; xOq;fhf kWMa;T nra;ag;gl Ntz;Lk;.
jdpahH chpkk; – ,d;Rypd; ,y;yhky; kUe;J tiffis itj;Jr; rkhspf;ff;$ba
kw;Wk; ePhpopT Neha;f;Fhpa ve;jtpj rpf;fYk; ,y;yhj ePhpopT NehAs;stHfs; Xl;LeH
chpk Mizaj;jplk; njhptpf;f Ntz;bajpy;iy. mtHfs; Ie;J tUlq;fSf;F
xUKiw kWMa;T nra;ag;gl Ntz;Lk;. (kw;w ‘Austroads’ msTNfhy;fisAk;
epiwT nra;a Ntz;Lk;). cq;fSf;F fLikahd my;yJ ehl;gl;l rpf;fy;fs;
,Ue;jhy;> cq;fSf;F rpfpr;ir mspf;Fk; kUj;Jtuhy; kWMa;T nra;ag;gl;lgpd;>
epge;jid chpkk;; toq;fg;glyhk;.
89
Diabetes and driving - continued
Commercial Licence – People with diabetes who are managed with insulin need to notify
the Drivers Licensing Authority in person. A conditional licence may be granted subject
to the opinion of the diabetes specialist, the nature of the driving task and annual review
(meeting all other Austroads criteria).
Other factors can affect your driver’s licence. Ask your doctor. Otherwise contact the Drivers
Licensing Authority in your State:
• Australian Capital Territory - Department of Urban Services
Phone: (02) 6207 7000
• New South Wales - Roads and Traffic Authority NSW
Phone: (02) 9218 6888
• Northern Territory - Department of Planning and Infrastructure
Phone: (08) 8924 7905
• Queensland - Queensland Transport
Phone: 13 23 80
• South Australia - Department of Transport, Energy and Infrastructure
Phone: (08) 8343 2222
• Tasmania - Department of Infrastructure Energy and Resources
Phone: 13 11 05
• Victoria - VicRoads
Phone: (03) 9854 2666
• Western Australia - Department for Planning and Infrastructure
Phone: 13 11 56
(08) 9427 8191
If you require further information access the Austroads website
http://www.austroads.com.au/aftd/index.html
90
ePhpopT NehAk;> thfdk; Xl;LjYk; - njhlUk;
tHj;jf chpkk; – ,d;Rypd; ,y;yhky; kUe;J tiffis itj;Jr; rkhspf;ff;$ba
ePhpopT NehAs;stHfs; Xl;LeH chpk Mizaj;jplk; njhptpf;f Ntz;Lk;. rpwg;G
kUj;Jthpd; fUj;J> thfdk; Xl;Lk; Ntiyapd; jd;ik kw;Wk; Fiwe;jgl;rk;
tUlj;Jf;F xUKiw kWMa;T ,itfspd; mbg;gilapy; epge;jid chpkk;;
toq;fg;glyhk; (kw;w ‘Austroads’ msTNfhy;fisAk; epiwT nra;a Ntz;Lk;).
jdpahH chpkk; – ,d;Rypd; nfhz;L rkhspf;ff;$ba ePhpopT NehAs;stHfs;
Xl;LeH chpk Mizaj;jplk; Neubahfj; njhptpf;f Ntz;Lk;. rpwg;G kUj;Jth; /
rpfpr;iraspf;Fk; kUj;Jthpd; fUj;J> thfdk; Xl;Lk; Ntiyapd; jd;ik kw;Wk;
Fiwe;jgl;rk; ,U tUlj;Jf;F xUKiw kWMa;T ,itfspd; mbg;gilapy;
epge;jid chpkk;; toq;fg;glyhk; (kw;w ‘Austroads’ msTNfhy;fisAk; epiwT
nra;a Ntz;Lk;).
tHj;jf chpkk; – ,d;Rypd; nfhz;L rkhspf;ff;$ba ePhpopT NehAs;stHfs;
Xl;LeH chpk Mizaj;jplk; Neubahfj; njhptpf;f Ntz;Lk;. ePhpopT Neha; rpwg;G
kUj;Jthpd; fUj;J> thfdk; Xl;Lk; Ntiyapd; jd;ik kw;Wk; tUlhe;jpu kWMa;T
,itfspd; mbg;gilapy; epge;jid chpkk;; toq;fg;glyhk; (kw;w ‘Austroads’
msTNfhy;fisAk; epiwT nra;a Ntz;Lk;).
kw;w fhuzpfSk; cq;fs; Xl;LeH chpkj;ijg; ghjpf;ff;$Lk;. cq;fs; kUj;Jtiuf;
Nfl;fTk;. ,y;yhtpby; cq;fs; khepyj;jpy; cs;s Xl;LeH chpk Mizaj;ijj;
njhlHG nfhs;sTk;:
• M];jpNuypaj; jiyefH gpuNjrk; – efHg;Gw Nritfs; jpizf;fsk;
njhiyNgrp: (02) 6207 7000
• epA+ rTj; Nty;]; - epA+ rTj; Nty;]; rhiyfs; kw;Wk; Nghf;Ftuj;J Mizak;
njhiyNgrp: (02) 9218 6888
• tlf;Fg; gpuNjrk; - jpl;lk; kw;Wk; cs;fl;likg;Gj; jpizf;fsk;
njhiyNgrp: (08) 8924 7905
• Fapd;];yhe;J – Fapd;];yhe;J Nghf;Ftuj;J
njhiyNgrp: 13 23 80
• njw;F M];jpNuypah – Nghf;Ftuj;J> Mw;wy; kw;Wk; cs;fl;likg;G jpizf;fsk;
njhiyNgrp: (08) 8343 2222
• lh];Nkdpah – cs;fl;likg;G> Mw;wy; kw;Wk; tsj; jpizf;fsk;
njhiyNgrp: 13 11 05
• tpf;Nlhhpah – tpf; (Vic) rhiyfs;
njhiyNgrp: (03) 9854 2666
• Nkw;F M];jpNuypah – jpl;lk; kw;Wk; cs;fl;likg;Gj; jpizf;fsk;
njhiyNgrp: 13 11 56
(08) 9427 8191
Nkyjpf tptuq;fs; cq;fSf;Fj; Njitg;gl;lhy;>
http://www.austroads.com.au/aftd/index.html vd;w ,izajsj;Jf;Fr; nry;yTk;
91
21
Diabetes and travel
Having diabetes does not mean your travelling days are over. To ensure you have a safe and
enjoyable trip, be sure to plan ahead. Good preparation may seem time consuming but it will
help to ensure you get the most out of your holiday.
• Discuss your travel plans with your doctor or diabetes educator. Also discuss medication
adjustments for situations you may encounter such as crossing time zones, or when
experiencing diarrhoea and/or nausea
• Carry several copies of a typed, signed letter from your doctor outlining your diabetes
management plan, medications, devices you use to give medication (if applicable) and
equipment needed to test your blood glucose level. You will also need
to carry scripts for all medications (clearly detailing your name), doctors
contact details, and both the name and type of medication, emergency
contacts and your National Diabetes Services Scheme card
• Always wear some form of identification that says you
have diabetes
• Pack more test strips, insulin, syringes, pens and other
diabetes equipment than you will need for the trip. If
possible, pack a spare meter in case of loss or damage
• Depending on your journey and destination, you may
need to consider taking an insulated travel pack for
your insulin
• Take a small approved sharps container for used lancets and syringes. Some airlines, hotels
and airports offer a sharps disposal service
• Keep insulin, syringes/pens and testing equipment in your hand luggage. Do not place
insulin in your regular luggage that will be placed in the cargo hold because it is not
temperature controlled. The insulin may be damaged or lost
• When flying, check with the airline in advance for specific security
guidelines as these are subject to change
• Customs regulations vary from country to country so it is advisable to
contact the embassy of the country you’re visiting before travelling
• When visiting some countries certain vaccinations are
recommended. Information in regard to vaccinations can be
obtained from your doctor
• The anticipation/stress of a trip or changes in routine may affect your
blood glucose (sugar) levels, so you may need to check your blood
glucose level more often
• Contact your airline about meal times and food available during
your flight. It is also recommended that you carry your own supply
of portable carbohydrates in case of unexpected meal delays or if
92
21
ePhpopT NehAk;> gazKk;
ePhpopT Neha; ,Ug;gjhy; cq;fs; gaz ehl;fs; Xa;e;J tpl;ld vd;gJ nghUsy;y.
cq;fSf;F ghJfhg;ghd kw;Wk; kfpo;r;rpahd gazj;ij cWjp nra;a> Kd;djhfj;
jpl;lkplTk;. ed;F jpl;lkpLk;NghJ Neuk; mjpfk; vLj;Jf;nfhs;tJ Nghy;
Njhd;wpdhYk;> cq;fs; tpLKiwia mjpfgl;rk; mDgtpf;f cjTfpwJ.
• cq;fs; gazj;jpl;lq;fis cq;fs; kUj;JtH my;yJ ePhpopT Neha;
fy;tpahshplk; fye;jhNyhrpAq;fs;. mj;Jld; Neu kz;lyj;ij fle;J Nghjy;
my;yJ tapw;Wg; Nghf;F kw;Wk;/my;yJ Fkl;ly; Vw;gLjy; Nghd;w #o;epiyfspy;
kUe;Jtiffisr; rhpnra;aTk; fye;jhNyhrpAq;fs;
•
cq;fs; ePhpopT Neha; epHthfj; jpl;lk;> kUe;J tiffs;> kUe;J
nfhLf;f ePqf
; s; gad;gLj;Jk; rhjdq;fs; (mg;gb vJTk; ,Ue;jhy;)
kw;Wk; cq;fs; ,uj;j FSNfh]; msitr; Nrhjpff
; j; Njitg;gLk;
cgfuzq;fs; ,itfisf; Fwpgg; plL
; cq;fs; kUj;JthplkpUe;J
jl;lr;R nra;ag;gl;Lf; ifnaOj;jplg;gl;l fbjj;jpd; gy efy;fis
cld; vLj;Jr; nry;Yq;fs;. mj;Jld; vy;yh kUe;JfSf;fhd
kUj;Jtr;rl
P L
; fs; (njspthff; Fwpgg; plg;gl;l
cq;fs; ngaUld;)> kUj;JtHfspd; njhlHG
tptuq;fs; kw;Wk; cq;fs; Njrpa ePhpopT
Neha; Nritfs; jpll
; ml;il vLj;Jr;nry;y
Ntz;bajpUf;Fk;
•
cq;fSf;F ePhpopT Neha; vd;W Fwpgg; pLk; VjhtJ
milahsj;ij vg;NghJk; mzpej
; pUq;fs;
• gazj;jpd; NghJ Njitf;F mjpfkhfNt Nrhjidg;
gl;ilfs;> ,d;Rypd>; kUe;J}rpfs;> Ngdhf;fs; kw;Wk; gpw ePHpopT Neha; cgfuzq;fs;
Nghd;witfis vLj;J itj;Jf;nfhs;Sq;fs;. KbAkhdhy;> njhiye;J NghFk; gl;rj;jpNyh
my;yJ NrjkilAk; gl;r
; j;jpNyh cghp kPll
; H xd;iw itj;Jf; nfhs;sTk;
•
cq;fs; gpuahzk; kw;Wk; NrUkplj;ijg; nghWj;J. cq;fs; ,d;RypDf;fhf ntg;gk; flj;jhj gazg;igia vLj;Jf; nfhz;L Nghf Ntz;bajpUf;fyhk;
• cgNahfpff
; g;gl;l
$Hf;fj;jpfs; kw;Wk; kUe;J}rpfSf;fhf rpW
nfhs;fyd; xd;iw vLj;Jf; nfhs;sTk;. rpy tpkhdq;fs;>
tpLjpfs; kw;Wk; tpkhd epiyaq;fs; kUe;J}rpfis
mg;Gwg;gLj;Jk; Nritia mspff
; pdw
; d
kUe;J}rpfs;/Ngdhf;fs; kw;Wk; Nrhjid
cgfuzq;fis cq;fs; ifg;igapDs; itj;Jf; nfhs;Sq;fs;.
,d;Rypid rhkhd;fs; itf;Fkplj;jpy; cs;s cq;fs; gazg;
ngl;bf;Fs; itf;f Ntz;lhk;. Vndd;why; mjpy; ntg;gf;
fl;Lg;ghl;L fpilahJ. ,d;Rypd; Nrjkilayhk; my;yJ
njhiye;J Nghfyhk;
• ,d;Rypd>;
• tpkhdg;
gazj;jpd; NghJ> ghJfhg;G topfhl;ly;fis Kd;$l;bNa
tpkhdr;Nritaplk; rhpghHj;Jf; nfhs;syhk;. Vndd;why; mit
khWjYf;Fl;gl;lit
93
Diabetes and travel - continued
you dislike the meal offered. If you take insulin with meals, do not give your insulin until your
meal arrives.
• To help prevent blood clots move about the cabin at regular intervals and do chair based
exercises. Drink plenty of water. Your doctor may advise you to wear support stockings
• If you are driving long distances make sure you stop regularly and take your blood glucose
levels before and during your trip
• Carry a small first aid kit with you in case of minor illness or injury.
Useful websites are www.dfat.gov.au and www.health.gov.au
Travel insurance is highly recommended. Make sure it covers situations which may arise in
relation to diabetes. The Australian Government has arrangements with some countries providing
benefits similar to Medicare, if needed. Remember to take your Medicare card with you.
For more information, call Medicare Australia on 132 011 or
visit: www.medicareaustralia.gov.au
At your destination
• Differences in activity, routines, food and stress may affect your blood glucose levels, check
your blood glucose levels more often
• Food options may differ from home. It is important to maintain carbohydrate intake. If
you are going to a different country do some research before you leave to help you make
appropriate food choices
• Take care with food and drink choices, particularly in developing countries where food
hygiene may not be adequate. Bottled water is preferable even for brushing teeth
• Protect your skin from sun burn
• Do not go barefoot. Be careful of hot sand and pavements. Check feet daily.
94
ePhpopT NehAk;> gazKk; - njhlUk;
• Rq;f tpjpKiwfs; ehl;Lf;F ehL NtWgLk;. MfNt gazk; nra;tjw;F Kd;Nd ePq;fs;
nry;yf;$ba ehl;bd; J}jufj;ijj; njhlHG nfhs;SkhW mwpTWj;jg;gLfpwJ
•
rpy ehLfSf;Fr; nry;Yk;NghJ rpy jLg;G kUe;Jfs; ghpe;Jiuf;fg;gLfpd;wd> jLg;G
kUe;Jfisg; gw;wpa jfty;fis cq;fs; kUj;JthplkpUe;J ngw;Wf; nfhs;syhk;
• gazk; my;yJ gazj;jpl;lj;jpy; khWjy; gw;wpa vjpHghHg;Gfs;/kd mOj;jk; cq;fs;
,uj;j FSNfh]; (rHf;fiu) msTfis ghjpf;fyhk;. MfNt ePq;fs; cq;fs; ,uj;j
FSNfh]; msit mbf;fb ghpNrhjid nra;a Ntz;bajpUf;fyhk;
• tpkhdg; gazj;jpd; NghJ> czT Neuq;fs; kw;Wk; fpilf;Fk; czT ,itfisg;
gw;wpa tptuq;fSf;F cq;fs; tpkhdr; Nritaplk; njhlHG nfhs;Sq;fs;. czT fpilf;f
vjpHghuhj fhyjhkjk; Vw;gLk; rkaj;jpy; my;yJ toq;fg;;gLk; czit ePq;fs; tpUk;ghj
gl;rj;jpy;> ePq;fs; jahH nra;j> nfhz;L nry;yf;$ba khTr;rj;Jf;fis vLj;Jr; nry;;yg;
ghpe;Jiuf;fg;gLfpwJ. ePq;fs; ,d;Rypid rhg;ghl;Lld; vLj;Jf; nfhs;s NeHe;jhy;> cq;fs;
rhg;ghL tUk;tiu ,d;Rypd; vLf;f Ntz;lhk;
• ,uj;j ciwjiyj; jLf;f cjTk; tifapy; Fwpg;gpl;l fhy ,ilntspapy; tpkhd
miwapd;
FWf;Fk; neLf;Fkhf elf;f Ntz;Lk;. mj;Jld; ehw;fhypapy; mkHe;jgbNa clw;gapw;rp
nra;a Ntz;Lk;. epiwa jz;zPH Fbf;f Ntz;Lk;. ghJfhg;Gf; fhYiw mzpa cq;fs;
kUj;JtH MNyhrid $wyhk;
• ePq;fs; ePz;l J}uk; gazpg;gtuhf ,Ue;jhy;> mq;fq;Nf epWj;jpr; nry;tijj; jtwhky;
cWjpg;gLj;jpf; nfhs;sTk;. mj;Jld; gazj;Jf;F Kd;Dk;> gazj;jpd; NghJk;
cq;fs; ,uj;j FSNfh]; msTfis vLj;Jf; nfhs;sTk;
• rpW RftPdk; my;yJ fhak; Vw;gLk; gl;rj;jpy; mtruj; Njitf;nfd cq;fSld;
KjYjtpg; ngl;b xd;iw vLj;Jr; nry;yTk;.
www.dfat.gov.au kw;Wk; www.health.gov.au Mfpait gaDs;s ,izajsq;fshFk;.
gazf; fhg;GWjp vd;gJ mjpfkhfg; ghpe;Jiuf;fg;gLfpwJ. mJ ePhpopT Neha; njhlHghd
#o;epiyfis cs;slf;fpAs;sjh vd;gij cWjpg;gLj;jpf; nfhs;Sq;fs;. Njitg;gl;lhy;
nkbNfiug; Nghd;w rYiffis toq;f M];jpNuypa muR rpy ehLfSld; Vw;ghLfs;
nra;Js;sJ. cq;fs; nkbNfH ml;ilia vLj;Jr; nry;y Ntz;Lk; vd;gij Qhgfj;jpy;
itj;Jf; nfhs;Sq;fs;.
Nkyjpf tptuq;fSf;F> nkbNfH M];jpNuypahit 132 011 vd;w vz;zpy; mioAq;fs;
my;yJ www.medicareaustralia.gov.au vd;w ,izajsj;Jf;Fr; nry;Yq;fs;.
ePq;fs; nry;Ykplj;jpy;
• nray;ghLfs;> tof;fkhd Ntiyfs;> czT kw;Wk; kd mOj;jk; Nghd;witfspy;
Vw;gLk; khw;wq;fs; cq;fs; ,uj;j FSNfh]; msTfisg; ghjpf;fyhk;. mbf;fb
cq;fs; ,uj;j FSNfh]; msTfisr; rhpghHj;Jf; nfhs;sTk;
• fpilf;Fk; czT tPl;by; fpilg;gijtpl tpj;jpahrkhdjhf ,Uf;fyhk;. khTr;rj;J
vLj;Jf;nfhs;tijj; njhlHtJ mtrpakhFk;. ePq;fs; NtnwhU ehl;Lf;Fr;
nry;tjhf ,Ue;jhy;> Gwg;gLtjw;F Kd; tpUg;gkhd czTfisj; NjHe;njLf;f
cjTk; tifapy; nfhQ;rk; Muha;r;rp nra;aTk
• czT Rfhjhuk; NghJkhd msT ,y;yhj tsUk; ehLfspy;> czT kw;Wk;
ghdq;fisj; NjHe;njLg;gjpy; ftdk; nrYj;Jq;fs;. gy; Jyf;Ftjw;Ff;$l
Gl;bePHjhd; tpUk;gg;gLfpwJ
• Ntdy;fl;bapdhy; ghjpf;fg;glhky; ,Uf;f cq;fs; Njhiyg; ghJfhj;Jf; nfhs;Sq;fs;.
• ntWq;fhYld; elf;fhjPHfs;. #lhd kzy; kw;Wk; eilghijfspy; ftdkhf ,Uf;fTk;.
xt;nthU ehSk; fhy;fis ghpNrhjid nra;J nfhs;sTk;.
95
22
Need an Interpreter?
A free telephone interpreter service is
available for people who may have difficulty
in understanding or speaking English. This
service is available through the Translating and
Interpreting Service (TIS) of the Department of
Immigration and Multicultural and Indigenous
Affairs (DIMIA).
TIS have access to professional interpreters in almost 2000 languages and dialects and can
respond immediately to most requests.
Accessing an interpreter:
Simply ring the Translating and Interpreting Service on 131 450
Explain the purpose for the call e.g. wanting to talk to an educator/dietitian at Australian
Diabetes Council.
The operator will connect you to an interpreter in the required language and to an Australian
Diabetes Council health professional for a three-way conversation.
This free service has been set up by the Australian Diabetes Council and will be promoted
with assistance from the Australian Government Department of Health and Ageing.
96
22
nkhopngaHj;Jiug;ghsH
Njitg;gLfpwjh?
Mq;fpyk; Ghpe;J nfhs;s my;yJ Ngrr;
rpukg;gLgtHfSf;F ,ytr njhiyNgrp
nkhopngaHj;Jiug;ghsH Nrit fpilf;Fk;.
FbtuT kw;Wk; gy;ypd kw;Wk; cs;ehl;L
tptfhu jpizf;fsj;jpd; (Department of
Immigration and Multicultural and Indigenous
Affairs - DIMIA) nkhopngaHg;G kw;Wk; nkhopngaHj;Jiug;Gr; Nrit (Translating and
Interpreting Service - TIS) topahf ,e;jr; Nrit fpilf;Fk;.
nkhopngaHg;G kw;Wk; nkhopngaHj;Jiug;Gr; Nrit> Vwf;Fiwa 2000 nkhopfs; kw;Wk;
tl;lhu nkhopfs; njhpe;j njhopy;rhH nkhopngaHj;Jiug;ghsHfspd; cjtpAld;
ngUk;ghyhd Nfhhpf;iffSf;F cldbahfg; gjpyspf;f KbAk;.
nkhopngaHj;Jiug;ghshplk; nry;Yjy;:
nkhopngaHg;G kw;Wk; nkhopngaHj;Jiug;Gr; Nritf;F 131 450 vd;w njhiyNgrp
vz;zpy; miof;fTk;
miog;gpw;fhd fhuzj;ij tpsf;fTk;. vLj;Jf;fhl;lhf> M];jpNuypa ePhpopT Neha;
fTd;rpypy; cs;s fy;tpahsH/czTf; fl;Lg;ghL epGzUld; Ngr tpUk;GfpNwd;.
njhiyNgrpia ,af;FgtH> cq;fis Njitg;gl;l nkhop NgRk;
nkhopngaHj;Jiug;ghsH kw;wk; M];jpNuypa ePhpopT Neha; fTd;rpy; Rfhjhu
njhopy;rhH epGzH MfpNahUld; %d;W top ciuahlYf;F ,izg;Gf; nfhLg;ghH.
,e;j ,ytr Nrit M];jpNuypa ePhpopT Neha; fTd;rpyhy; Vw;ghL
nra;ag;gl;bUf;fpwJ. ,J M];jpNuypa muR Rfhjhuk; kw;Wk; KJik
jpizf;fsj;jpdhy; (Australian Government Department of Health and Ageing)
Cf;Ftpf;fg;gLfpwJ.
97
23
National Diabetes Services Scheme (NDSS)
The NDSS is a federal government funded program, administered on behalf of the
government by Australian Diabetes Council.
The NDSS provides free syringes and needles for those requiring insulin, as well as blood and
urine testing strips at subsidised prices to those who are registered.
Registration is free and you are only required to register once unless your treatment changes
to require insulin.
You do not need a doctor’s prescription to purchase NDSS products for diabetes
management.
Registering for the NDSS
Once you have been diagnosed with diabetes, your doctor or credentialled diabetes
educator can register you with the NDSS. If you are not sure whether you are registered with
the NDSS, or want more information, call Australian Diabetes Council on 1300 342 238.
Where to buy NDSS products
You can buy products at Australian Diabetes Council offices or through pharmacy sub agents.
You can also order your products from Australian Diabetes Council by phoning 1300 342 238
or visiting www.australiandiabetescouncil.com.
Your products will be mailed to you free of charge.
Who should register for the NDSS?
Australian residents that have been diagnosed with diabetes by a doctor and who hold a
current Australian Medicare card or Department of Veteran Affairs file number should register.
If you are a visitor to Australia and from a country with a Reciprocal Health Care Agreement,
you may be entitled to temporary registration to the NDSS.
Please call Australian Diabetes Council on 1300 342 238 for further information.
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Njrpa ePhpopT Neha; Nritfs; jpl;lk;
(NDSS)
Njrpa ePhpopT Neha; Nritfs; jpl;lk; vd;gJ xU kj;jpa muR epjpAjtp ngWk; jpl;lkhFk;.
,J murpd; rhHgpd; M];jpNuypa ePhpopT Neha; fTd;rpypdhy; elj;jg;gLfpwJ.
Njrpa ePhpopT Neha; Nritfs; jpl;lk; ,ytr kUe;J}rpfisAk;> CrpfisAk; ,d;Rypd;
Njitg;gLgtHfSf;F toq;FfpwJ. mj;Jld; ,uj;jk; kw;Wk; rpWePH Nrhjidg; gl;ilfisg;
gjpT nra;ag;gl;ltHfSf;Ff; Fiwe;j tpiyapy; toq;FfpwJ.
gjpT ,ytrk;. mj;Jld; ,d;Rypd; Njitf;fhf cq;fs; rpfpr;ir khWk;NghJ jtpHj;J>
ePq;fs; xU Kiw gjpTnra;jhy; kl;Lk; NghJkhdJ.
ePhpopT Neha; epHthfj;Jf;fhfj; Njrpa ePhpopT Neha; Nritfs; jpl;lg; nghUl;fis
thq;Ftjw;F> kUj;Jthpd; kUe;Jr; rPl;L Njitapy;iy.
Njrpa ePhpopT Neha; Nritfs; jpl;lj;jpy; gjpT nra;jy;
cq;fSf;F ePhpopT Neha; ,Ug;gjhff; fz;Lgpbf;fg;gl;lTlNd> cq;fs; kUj;JtH my;yJ
mq;fPfhpf;fg;gl;l ePhpopT Neha; fy;tpahsH cq;fisj; Njrpa ePhpopT Neha; Nritfs;
jpl;lj;jpy; gjpT nra;thH. ePq;fs; Njrpa ePhpopT Neha; Nritfs; jpl;lj;jpy; gjpT
nra;ag;gl;bUf;fpwPHfsh vd;gJ cq;fSf;F cWjpahfj; njhpatpy;iynad;whNyh my;yJ
mjpf tptuq;fs; Ntz;Lnkd;whNyh M];jpNuypa ePhpopT Neha; fTd;rpiy 1300 342 238
vd;w vz;zpy; miof;fTk;.
Njrpa ePhpopT Neha; Nritfs; jpl;lg; nghUl;fis vq;Nf thq;FtJ
ePq;fs; nghUl;fis M];jpNuypa ePhpopT fTd;rpy; mYtyfq;fspNyh> kUe;Jf;fil cg
KftHfs; %ykhfNth thq;f KbAk;. ePq;fs; cq;fs; nghUl;fis M];jpNuypa ePhpopT
fTd;rpyplkpUe;Jk; 1300 342 238 vd;w vz;Zf;F njhiyNgrpapy; NgRtjd; %yNkh
my;yJ www.australiandiabetescouncil.com vd;w ,izajsj;Jf;Fr; nry;tjd; %yNkh
thq;fpf; nfhs;syhk;. cq;fs; nghUl;fs; ,ytrkhf cq;fSf;F mQ;rypy; mDg;gp
itf;fg;gLk;.
Njrpa ePhpopT Neha; Nritfs; jpl;lj;jpy; ahH gjpT nra;a KbAk;?
xU kUj;Jtuhy; ePhpopT Neha; ,Uf;fpwnjd fz;lwpag;gl;l M];jpNuypaf; FbAhpik
ngw;wtHfs;> M];jpNuypa nkbNfH ml;il my;yJ KjpNahH tptfhu jpizf;fs Nfhg;G
vz; (Department of Veteran Affairs file number) itj;jpUe;jhy; gjpT nra;a Ntz;Lk;.
ePq;fs; M];jpNuypahTf;F xU tpUe;jpduha;> gu];gu Rfhjhug; guhkhpg;G xg;ge;jk; cs;s
ehl;bypUe;J te;jpUe;jhy;> Njrpa ePhpopT Neha; Nritfs; jpl;lj;jpy; jw;fhypfg; gjpT
nra;aj; jFjpAilatuha; ,Uf;fyhk;.
Nkyjpf tptuq;fSf;Fj; jaTnra;J M];jpNuypa ePhpopT fTd;rpiy 1300 342 238 vd;w
vz;zpy; miof;fTk;.
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24
Australian Diabetes Council Australian Diabetes Council is a non-profit, non-government charity dedicated to helping all
people with diabetes. It provides:
• education programs
• conducts public awareness campaigns
• funds research into diabetes management and the search for a cure
• advocacy, (protecting the rights of people with diabetes).
Australian Diabetes Council has a network of branches and support groups to provide
support and encouragement for people affected by diabetes.
Our Customer Care Line has diabetes educators, dietitians and exercise physiologists available
to provide personalised and practical assistance to benefit people with diabetes and their
carers.
To find out about all the benefits of becoming a member of the Australian Diabetes Council
contact 1300 342 238.
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24
M];jpNuypa ePhpopT Neha;f; fofk;
M];jpNuypa ePhpopT Neha;f; fofk; vd;gJ ePhpopT Nehahspfs; midtUf;Fk;
cjtp nra;Ak; Nehf;fj;jpy; mHg;gzpf;fg;gl;l xU ,yhg Nehf;fpy;yhj> muR rhuh
mwf;fl;lisahFk;. mJ toq;Fk; Nritfs;:
• fy;tp epfo;r;rpj; jpl;lk;
• kf;fs; tpopg;GzHTg; gpur;rhuj;ij elj;Jjy;
• ePhpopT Neha; epHthfj;Jf;fhd Muha;r;rpf;Fk;> Fzg;gLj;Jtjw;fhd
NjlYf;Fk; epjpAjtp nra;jy;
• JizNghFk; typik (ePhpopT Nehahspfspd; chpikfisg; ghJfhj;jy;).
M];jpNuypa ePhpopTf; fofk; tiyg;gpd;dy; Nghy; fpisfs; nfhz;Ls;sJ. NkYk;
mJ ePhpopT Nehahy; ghjpf;fg;gl;ltHfSf;F MjuTk;> Cf;Ftpg;Gk; toq;f MjuTf;
FOf;fisAk; nfhz;Ls;sJ.
vq;fs; thbf;ifahsH guhkhpg;G ,izg;ghdJ> ePhpopT Neha;f; fy;tpahsHfs;>
czTf; fl;Lg;ghL epGzHfs; kw;Wk; clw;gapw;rp clypayhsHfisf; nfhz;Ls;sJ.
ePhpopT Nehahspfs; kw;Wk; mtHjk; guhkhpg;ghsHfs; eyk; ngw jdpg;gl;l kw;Wk;
eilKiw cjtpfis mtHfs; toq;FfpwhHfs;.
M];jpNuypa ePhpopT Neha;f; fofj;jpy; mq;fj;jpduhtjhy; Vw;gLk; vy;yh
ed;ikfisg; gw;wpAk; mwpe;J nfhs;s 1300 342 238 vd;w vz;zpy; njhlHG
nfhs;Sq;fs;.
101
102
103
For more information call us on
Street address
26 Arundel Street
Glebe NSW 2037
ABN 84 001 363 766 CFN 12458
Postal address
GPO Box 9824
Sydney NSW 2001
Customer Care Line
1300 diabetes
1300 342 238
Phone +61 2 9552 9900
Fax +61 2 9660 3633
© 2012 Australian Diabetes Council. May not be reproduced in whole or in part without prior permission.

Tamil - Diabetes NSW

Transcription

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